DEVICES AND METHODS FOR MINIMALLY INVASIVE KIDNEY STONE REMOVAL BY COMBINED ASPIRATION AND IRRIGATION
Disclosed herein are systems, devices, and methods for the removal of objects from the body. The device may be a urethral catheter configured to aspirate kidney stones from the urinary tract through one or more aspiration ports at the distal face or along a lateral side of the catheter. The catheter may include one or more irrigation ports at the distal face or along the lateral side of the catheter for dislodging kidney stones. The device may be steerable. The spatial arrangement of the one or more irrigation ports with respect to the one or more aspiration ports may vary. The device may include an irrigation tube and/or a shield member configured to spatially confine the kidney stones adjacent the catheter. Various temporal patterns of aspiration and irrigation are disclosed for optimizing removal of kidney stones.
1 .- 249 . (canceled)
250 . A catheter for removal of kidney stones, comprising:
a handle portion coupled to a flexible tube portion, the tube portion comprising a vacuum lumen and an irrigation lumen;
a distal face of the tube portion comprising a plurality of irrigation ports in fluid communication with the irrigation lumen and an aspiration port, wherein the aspiration port has an inner diameter larger than the inner diameter of any one of the plurality of irrigation ports; and
a plurality of pull wires running from a tube portion distal section to one or more wire pull members on the handle portion, wherein pulling on one or more the pull wires using the wire pull members causes the tube portion distal section to bend in one or more directions.
251 . The catheter of claim 250 , wherein the catheter is configured to allow stone transport through the vacuum lumen when the tube portion distal section is bent to form a curve in the range of about 100 degrees to about 200 degrees.
252 . The catheter of claim 250 , wherein the irrigation lumen is fixed with respect to the vacuum lumen.
253 . The catheter of claim 250 , wherein the tube portion comprises one irrigation lumen and all of the plurality of irrigation ports are in fluid communication with the one irrigation lumen.
254 . The catheter of claim 250 , wherein at least one of the plurality of irrigation ports is configured to create an irrigation stream that extends radially outward away from a longitudinal axis of the catheter.
255 . The catheter of claim 254 , wherein all of the plurality of irrigation ports are configured to create an irrigation stream that extends radially outward away from the longitudinal axis of the catheter.
256 . The catheter of claim 250 , wherein the plurality of irrigation ports is configured to create an irrigation stream that diverges away from a longitudinal axis of the catheter.
257 . The catheter of claim 250 , further comprising a nozzle incorporated into the tube portion distal section and the nozzle forms the distal face of the tube portion.
258 . The catheter of claim 250 , wherein the plurality of irrigation ports is configured to produce laminar flow.
259 . The catheter of claim 250 , wherein the plurality of irrigation ports is configured to produce turbulent flow.
260 . The catheter of claim 250 , wherein the vacuum lumen has an inner diameter greater than 2 mm.
261 . The catheter of claim 260 , wherein the vacuum lumen has an inner diameter less than 2.5 mm.
262 . The catheter of claim 250 , wherein the vacuum lumen has an inner diameter of about 2.5 mm.
263 . The catheter of claim 250 , wherein each pull wire extends through a wall of the tube portion.
264 . The catheter of claim 250 , wherein the catheter further comprises a direct visualization device.
265 . The catheter of claim 250 , wherein the catheter further comprises a direct visualization device configured to be movable within the vacuum lumen.
266 . The catheter of claim 265 , wherein the direct visualization device is configured to be removed from within the vacuum lumen.
267 . The catheter of claim 266 , wherein direct visualization device is configured to be removed from within the vacuum lumen prior to stone transport through the vacuum lumen.