Medical system and method of use
View Patent ↗Systems and methods for resecting prostate tissue and applying thermal energy to prostate tissue before, during or after resection to prevent bleeding or coagulate bleeding in surfaces of prostate tissue in benign prostatic hyperplasia treatments.
1 . A method of liquid jet cutting of soft tissue, comprising:
providing a working end of a shaft of a tissue cutting device with a first member having a first flow channel configured to propagate a first liquid jet stream outwardly in a first vector and a second member having a second flow channel configured to propagate a second liquid jet stream outwardly in a second vector;
positioning the working end in an interface with a targeted tissue; and
propagating the first liquid jet stream and the second liquid jet stream outwardly at selected pressure parameters that provide kinetic energy in the first liquid jet stream and the second liquid jet stream to cut the targeted tissue;
wherein the first vector and the second vector converge at an outward point of convergence to thereby induce turbulence adapted to dissipate the kinetic energy of the first liquid jet stream and the second liquid jet stream to control a cutting depth; and
adjusting the outward point of convergence during an interval of propagating the first liquid jet stream and the second liquid jet stream.
2 . The method of claim 1 , wherein the first vector and the second vector extend outwardly from an axis of the shaft at an angle ranging from 30° to 90°.
3 . The method of claim 1 , wherein the outward point of convergence is outward from an axis of the shaft from 5 mm to 25 mm.
4 . The method of claim 1 , further comprising moving the first liquid jet stream and the second liquid jet stream at least one of helically, rotationally or axially during an interval of propagating the first liquid jet stream and the second liquid jet stream.
5 . The method of claim 4 , wherein moving the first liquid jet stream and the second liquid jet stream is provided by a motor drive that moves the working end.
6 . The method of claim 1 , wherein adjusting the outward point of convergence comprises using a motor drive that adjusts a spacing between a first jet orifice and a second jet orifice that propagate the first liquid jet stream and the second liquid jet stream respectively.
7 . The method of claim 1 , further comprising propagating a vapor jet from the working end, wherein a subsequent vapor-to-liquid phase transition applies cauterizing energy to the targeted tissue.
8 . The method of claim 7 , wherein propagating the vapor jet occurs before propagating the first liquid jet stream and the second liquid jet stream.
9 . The method of claim 7 , wherein propagating the vapor jet occurs contemporaneously with propagating the first liquid jet stream and the second liquid jet stream.
10 . The method of claim 7 , wherein propagating the vapor jet and propagating the first liquid jet stream and the second liquid jet stream are done sequentially.
11 . The method of claim 7 , wherein propagating the vapor jet occurs after propagating the first liquid jet stream and the second liquid jet stream to cut a volume of the targeted tissue.
12 . The method of claim 1 , further comprising actuating a negative pressure source communicating with the working end to extract tissue debris and liquid after the first liquid jet stream and the second liquid jet stream cut a volume of the targeted tissue.
13 . A medical system for liquid jet cutting and cauterization of soft tissue, comprising:
a housing coupled to an elongate shaft configured for trans-urethral introduction to a patient's prostatic urethra;
a working end of the elongate shaft including a first jet orifice configured to propagate a first liquid jet stream outwardly in a first vector and a second jet orifice configured to propagate a second liquid jet stream outwardly in a second vector wherein the first vector and the second vector converge at a point of convergence outward from an axis of the working end;
a controller coupled to a motor drive configured to adjust an axial spacing between the first jet orifice and the second jet orifice; and
a vapor jet outlet in the working end configured to propagate a vapor jet stream outwardly from the working end.
14 . The medical system of claim 13 , further comprising at least one motor drive operated by the controller to move the working end at least one of helically, rotationally and axially.
15 . The medical system of claim 13 , wherein the first vector and the second vector extend outwardly from the axis of the working end at angle ranging from 30° to 90°.
16 . The medical system of claim 13 , wherein the point of convergence is outward from the axis of the working end from 5 mm to 25 mm.
17 . The medical system of claim 13 , further comprising a negative pressure source communicating with the working end configured to extract tissue debris and liquid from a treatment site.
18 . The medical system of claim 17 , wherein the controller is configured to control an extraction outflow to maintain pressure in a selected pressure range in the treatment site.
19 . The medical system of claim 13 , wherein the elongate shaft carries first and second occlusion members for positioning proximally and distally of a prostatic urethra.
20 . A method of liquid jet cutting of soft tissue, comprising:
providing a working end of a shaft of a tissue cutting device with a first member having a first flow channel configured to propagate a first liquid jet stream outwardly in a first vector and a second member having a second flow channel configured to propagate a second liquid jet stream outwardly in a second vector;
positioning the working end in an interface with a targeted tissue; and
propagating the first liquid jet stream and the second liquid jet stream outwardly at selected pressure parameters that provide kinetic energy in the first liquid jet stream and the second liquid jet stream to cut the targeted tissue;
wherein the first vector and the second vector converge at an outward point of convergence to thereby induce turbulence adapted to dissipate the kinetic energy of the first liquid jet stream and the second liquid jet stream to control a cutting depth, and
adjusting an axial spacing between the first liquid jet stream and the second liquid jet stream to adjust the outward point of convergence.
21 . The method of claim 20 , further comprising propagating a vapor jet from the working end, wherein a subsequent vapor-to-liquid phase transition applies cauterizing energy to the targeted tissue.
22 . The method of claim 21 , wherein propagating the vapor jet occurs before propagating the first liquid jet stream and the second liquid jet stream.
23 . The method of claim 21 , wherein propagating the vapor jet occurs contemporaneous with propagating the first liquid jet stream and the second liquid jet stream.
24 . The method of claim 21 , wherein propagating the vapor jet and propagating the first liquid jet stream and the second liquid jet stream are done sequentially.
25 . The method of claim 21 , wherein propagating the vapor jet occurs after propagating the first liquid jet stream and the second liquid jet stream to cut a volume of the targeted tissue.