Implant delivery methods
Aspects of the present invention relate to a method for locating an expandable implant for treating BPH within the prostatic urethra of a patient. The delivery device comprises an inner tube and an outer sleeve moveable relative to the inner tube between a stored position and a deployed position. The outer sleeve surrounds the inner tube to define an annulus therebetween and the expandable implant is retained within the annulus when the outer sleeve is in the stored position.
1. A method of treating benign prostatic hyperplasia, the method comprising;
inserting a distal end of an outer sleeve of an implant delivery device through a urethra,
the outer sleeve comprising a hollow distal segment holding an implant in a contracted state,
the implant being self-expandable from the contracted state to an expanded state,
the implant comprising a single filament bent to comprise a plurality of proximal apices, a plurality of distal apices, and a plurality of struts extending between the proximal apices and the distal apices,
the delivery device comprising a handle comprising an actuator,
the outer sleeve extending distally from the handle,
the delivery device comprising an inner tube comprising a plurality of proximal protrusions and a plurality of distal protrusions, each of the plurality of proximal protrusions paired with one of the plurality of distal protrusions to form a plurality of slots each containing one of the plurality of proximal apices of the implant, the plurality of proximal protrusions configured to inhibit proximal movement of the implant in the delivery device and the plurality of distal protrusions configured to inhibit distal movement of the implant in the delivery device and to inhibit rotational movement of the implant relative to the inner tube,
the actuator being operable to retract the outer sleeve,
the delivery device comprising a light emitter, and
the delivery device comprising an imaging device;
operating the actuator to partially retract the outer sleeve so that the implant is partially uncovered, and so that the proximal apices contained in the plurality of slots prior to the outer sleeve being partially retracted remain contained in the plurality of slots after the outer sleeve is partially retracted;
illuminating the urethra with the light emitter;
rotationally orienting the partially uncovered implant with respect to anatomical features of the urethra while using the imaging device; and
operating the actuator to further retract the outer sleeve to deliver the implant in the urethra aligned with prostatic lobes of the urethra and so a verumontanum and seminal ducts are unobstructed.
2. The method of claim 1 , wherein the anatomical features comprise at least one of a prostatic lobe, a bladder neck, or the verumontanum.
3. The method of claim 1 , wherein operating the actuator to partially retract the outer sleeve comprises moving a safety catch to a first position, and wherein operating the actuator to further retract the outer sleeve comprises moving the safety catch to a second position different than the first position.
4. The method of claim 1 , wherein inserting the distal end of the outer sleeve of the implant delivery device through the urethra comprises steering the delivery device.
5. The method of claim 1 , wherein after delivering the implant in the urethra the implant is between a bladder neck and an external sphincter.
6. The method of claim 1 , wherein operating the actuator to partially retract the outer sleeve comprises proximally retracting the imaging device to provide a view of the plurality of distal apices relative to the anatomical features of the urethra to aid orientation and placement of the implant.
7. A method of treating benign prostatic hyperplasia, the method comprising:
inserting a distal end of an outer sleeve of an implant delivery device through a urethra,
the outer sleeve comprising a hollow distal segment holding an implant in a contracted state,
the implant being expandable from the contracted state to an expanded state,
the implant comprising a plurality of proximal apices, a plurality of distal apices, and a plurality of struts extending between the proximal apices and the distal apices,
the delivery device comprising a handle comprising an actuator,
the outer sleeve extending distally from the handle,
the delivery device comprising an inner tube comprising a space engaging one of the plurality of proximal apices of the implant, and
the delivery device comprising an imaging device;
operating the actuator to change a relative longitudinal position between the inner tube and the outer sleeve so that the implant is partially uncovered and so that the one of the plurality proximal apices engaged with the space prior to the implant being partially uncovered remains engaged with space after the implant is partially uncovered;
rotationally orienting the partially uncovered implant with respect to anatomical features of the urethra while using the imaging device; and
operating the actuator to further change the relative longitudinal position between the inner tube and the outer sleeve to deliver the implant in the urethra aligned with prostatic lobes of the urethra.
8. The method of claim 7 , wherein the anatomical features comprise at least one of a prostatic lobe, a bladder neck, or a verumontanum.
9. The method of claim 7 , wherein operating the actuator to change the relative longitudinal position between the inner tube and the outer sleeve comprises moving a safety catch.
10. The method of claim 7 , wherein inserting the distal end of the outer sleeve of the implant delivery device through the urethra comprises steering the delivery device.
11. The method of claim 7 , wherein after delivering the implant in the urethra the implant is between a bladder neck and an external sphincter.
12. The method of claim 7 , wherein the inner tube comprises a proximal protrusion and a distal protrusion, and wherein the space comprises a gap between the proximal protrusion and the distal protrusion.
13. The method of claim 7 , wherein the inner tube comprises a plurality of spaces each engaging one of the plurality of proximal apices of the implant.
14. The method of claim 7 , wherein the anatomical features comprise at least one of a prostatic lobe, a bladder neck, or a verumontanum, wherein inserting the distal end of the outer sleeve of the implant delivery device through the urethra comprises steering the delivery device, and wherein after delivering the implant in the urethra the implant is between a bladder neck and an external sphincter.
15. A method of treating benign prostatic hyperplasia, the method comprising:
inserting a distal end of an outer sleeve of an implant delivery device through a urethra,
the outer sleeve comprising a hollow distal segment holding an implant in a contracted state,
the implant expandable from the contracted state to an expanded state,
the delivery device comprising a handle comprising an actuator,
the outer sleeve extending distally from the handle, and
the delivery device comprising an imaging device;
operating the actuator to partially uncover the implant; and
rotationally orienting the partially uncovered implant with respect to anatomical features of the urethra while using the imaging device.
16. The method of claim 15 , wherein the anatomical features comprise at least one of a prostatic lobe, a bladder neck, or a verumontanum.
17. The method of claim 15 , wherein operating the actuator comprises moving a safety catch.
18. The method of claim 15 , wherein inserting the distal end of the outer sleeve of the implant delivery device through the urethra comprises steering the delivery device.
19. The method of claim 15 , further comprising operating the actuator to deliver the implant in the urethra.
20. The method of claim 19 , wherein after delivering the implant in the urethra the implant is aligned with prostatic lobes of the urethra.
21. The method of claim 19 , wherein after delivering the implant in the urethra the implant is between a bladder neck and an external sphincter.
22. The method of claim 15 , wherein operating the actuator to partially uncover the implant comprises proximally retracting the imaging device.
23. The method of claim 22 , wherein the proximally retracted imaging device provides a view of thea plurality of distal apices relative to the anatomical features of the urethra to aid orientation and placement of the implant.
24. The method of claim 22 , wherein the proximally retracted imaging device provides a view from inside the a plurality of distal apices.
25. The method of claim 15 , further comprising operating the actuator to deliver the implant in the urethra, wherein the anatomical features comprise at least one of a prostatic lobe, a bladder neck, or a verumontanum, and wherein inserting the distal end of the outer sleeve of the implant delivery device through the urethra comprises steering the delivery device.
26. The method of claim 7 , wherein operating the actuator to change the relative longitudinal position between the inner tube and the outer sleeve comprises proximally retracting the imaging device.
27. The method of claim 26 , wherein the proximally retracted imaging device provides a view from inside the plurality of distal apices.