Object removal through a percutaneous suction tube
A method is described for using percutaneous access to a patient to remove an object from a cavity within the patient. The method includes inserting a suction tube into a port created by a percutaneous cut. An endoscope is also advanced into the cavity, however the endoscope passes through a patient lumen rather than through the port. Using a working channel within the endoscope, fluid is irrigated through the cavity. Additionally, a negative pressure is applied to the suction tube, such that the combination of fluid irrigation and negative pressure assist in removing the object from the cavity through the suction tube.
1. A method for removing an object from a patient, comprising:
inserting a suction tube into a patient's kidney through a port created by a percutaneous cut;
advancing an endoscope into the patient's kidney by inserting the endoscope through a natural orifice in the patient and then through a patient lumen other than the port and into the kidney, the endoscope comprising a working channel;
irrigating the patient's kidney with a fluid, where the fluid passes within the working channel of the endoscope; and
applying negative pressure to the suction tube, the combination of the fluid irrigation and the negative pressure assisting in causing the object to be removed from the patient's kidney through the suction tube.
2. The method of claim 1 , further comprising:
directing a surgical tool into the patient's kidney through the port; and
manipulating the surgical tool to assist in removing the object through the suction tube.
3. The method of claim 2 , wherein the surgical tool is inserted within the suction tube.
4. The method of claim 2 , wherein the surgical tool is a laser or optical fiber, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
performing lithotripsy on the object to break it apart.
5. The method of claim 2 , wherein the surgical tool is a chisel or drill, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
respectively, chiseling or drilling the object to break it apart.
6. The method of claim 2 , wherein the surgical tool is an ultrasound device, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
activating the ultrasound device to break apart the object with sound waves.
7. The method of claim 2 ,
wherein a surgical tool configured to assist in removing the object through the suction tube is integrated into the suction tube.
8. The method of claim 7 , wherein the surgical tool is a laser or optical fiber, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
performing lithotripsy on the object to break it apart.
9. The method of claim 7 , wherein the surgical tool is a chisel or drill, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
respectively, chiseling or drilling the object to break it apart.
10. The method of claim 7 , wherein the surgical tool is an ultrasound device, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
activating the ultrasound device to break apart the object with sound waves.
11. The method of claim 1 , further comprising:
inserting a surgical tool through the working channel of the endoscope into the patient cavity; and
manipulating the surgical tool to assist in removing the object through the suction tube.
12. The method of claim 11 , further comprising:
wherein the fluid passes on the outside of the surgical tool within the working channel of the endoscope.
13. The method of claim 11 , further comprising:
wherein the surgical tool is a basket apparatus comprising an outer support shaft and a plurality of peripheral channels threaded with pull wires.
14. The method of claim 11 , wherein the surgical tool is at least one from the group consisting of a laser or optical fiber, an ultrasound device, a chisel, a drill, and a grasper.
15. The method of claim 11 , further comprising:
wherein the surgical tool comprises a tool working channel; and
wherein the fluid passes within the tool working channel of the surgical tool.
16. The method of claim 11 , further comprising:
wherein the surgical tool is a basket apparatus comprising a working channel;
the method further comprising inserting a second surgical tool within the working channel of the basket apparatus to assist in removing the object from the cavity through the suction tube.
17. The method of claim 16 , wherein the second surgical tool is at least one from the group consisting of a laser or optical fiber, an ultrasound device, a chisel, and a drill.
18. The method of claim 11 , wherein the surgical tool is a basket apparatus, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
capturing the object within a basket of the basket apparatus and positioning the stone proximate to the suction tube.
19. The method of claim 11 , wherein the surgical tool is a laser or optical fiber, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
performing lithotripsy on the object to break it apart.
20. The method of claim 11 , wherein the surgical tool is a chisel or drill, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
respectively, chiseling or drilling the object to break it apart.
21. The method of claim 11 , wherein the surgical tool is an ultrasound device, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
activating the ultrasound device to break apart the object with sound waves.
22. The method of claim 1 , the method further comprising:
extending a leaderscope disposed within the working channel of the endoscope beyond the distal tip of the endoscope;
inserting a surgical tool down a working channel within the leaderscope into the patient cavity; and
manipulating the surgical tool to assist in removing the object through the suction tube.
23. The method of claim 22 , wherein the surgical tool is at least one of a laser or optical fiber, an ultrasound device, a chisel, a drill, and a grasper.
24. The method of claim 22 , further comprising:
wherein the fluid passes on the outside of the leaderscope within the working channel of the endoscope.
25. The method of claim 22 , wherein the surgical tool is a laser or optical fiber, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
performing lithotripsy on the object to break it apart.
26. The method of claim 22 wherein the surgical tool is a chisel or drill, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
respectively, chiseling or drilling the object to break it apart.
27. The method of claim 22 , wherein the surgical tool is an ultrasound device, and manipulating the surgical tool to assist in removing the object through the suction tube comprises:
activating the ultrasound device to break apart the object with sound waves.
28. The method of claim
wherein the step of inserting the suction tube into the port is performed by a first robotic arm; and
wherein the step of advancing the endo scope through cavity is performed by a second robotic arm.
29. The method of claim 1
wherein the endoscope comprises of a sheath and leaderscope, and
wherein the step of advancing the endoscope through cavity is performed by a first robotic arm advancing the sheath and a second robotic arm advancing the leaderscope.
30. The method of claim 1 wherein the object is at least one from the group consisting of: a kidney stone or a bladder stone, a stow formed from at least one of calcium, magnesium, ammonia, uric acid, and cysteine.
31. The method of claim 1 , wherein the patient lumen includes a patient's urethra.