# US 10,653,438 B2 · Automated image-guided tissue resection and treatment > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,653,438 B2 - Document ID: US10653438B2 - Status: Granted - Kind: B2 - Application number: 15/593,158 - Filed: 2017-05-11 - Published: 2017-08-31 - Granted: 2020-05-19 - Earliest claimed: 2012-02-29 - Assignees: PROCEPT BioRobotics Corporation - Applicants: PROCEPT BioRobotics Corporation - Inventors: Nikolai Aljuri; Surag Mantri; Luis Baez; George Surjan; Michael W. Sasnett; Jonathan Foote - Web page: https://patentgrep.com/patent/US10653438B2 ## CPC - A61B 17/3203: Fluid jet cutting instruments - A61B 1/307: for the urinary organs, e.g. urethroscopes or cystoscopes - A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/32037: {for removing obstructions from inner organs or blood vessels, e.g. for atherectomy} - A61B 18/04: by heating (by applying electromagnetic radiation A61B18/18) - A61B 18/1485: {having a short rigid shaft for accessing the inner body through natural openings} - A61B 34/25: {User interfaces for surgical systems} - A61B 90/37: {Surgical systems with images on a monitor during operation} - A61B 18/20: using laser - A61B 34/30: Surgical robots - A61B 2017/00199: {with a console, e.g. a control panel with a display} - A61B 2017/00274: {Prostate operation, e.g. prostatectomy, turp, bhp treatment} - A61B 2017/306: {holding by means of suction} - A61B 2018/00279: {deployable} - A61B 2018/00285: {Balloons} - A61B 2018/00327: {Ear, nose or throat} - A61B 2018/00351: {Heart} - A61B 2018/00404: {Blood vessels other than those in or around the heart} - A61B 2018/0044: {Spinal cord} - A61B 2018/00446: {Brain} - A61B 2018/00488: {Esophagus} - A61B 2018/00494: {Stomach, intestines or bowel} - A61B 2018/005: {Rectum} - A61B 2018/00517: {Urinary bladder or urethra} - A61B 2018/00529: {Liver} - A61B 2018/00541: {Lung or bronchi} - A61B 2018/00547: {Prostate} - A61B 2018/00577: {Ablation} - A61B 2018/00589: {Coagulation} - A61B 2018/00595: {Cauterization} - A61B 2018/00601: {Cutting} - A61B 2018/00607: {Coagulation and cutting with the same instrument} - A61B 2018/00642: {with feedback, i.e. closed loop control} - A61B 2018/0066: {without feedback, i.e. open loop control} - A61B 2018/00982: {combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes} - A61B 2018/00994: {combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound} - A61B 2018/046: {in liquid form} - A61B 2018/1472: {for use with liquid electrolyte, e.g. virtual electrodes} - A61B 2018/20351: {Scanning mechanisms} - A61B 2018/205: {with electronic means, e.g. acousto-optic} - A61B 2018/20554: {Arrangements for particular intensity distribution, e.g. tophat} - A61B 2018/2211: {Plurality of fibres} - A61B 2018/2272: {with reflective or refractive surfaces for deflecting the beam (A61B2018/2261, A61B2018/2266 take precedence)} - A61B 2034/107: {Visualisation of planned trajectories or target regions} - A61B 2034/2048: {using an accelerometer or inertia sensor} - A61B 2034/254: {being adapted depending on the stage of the surgical procedure} - A61B 2090/064: {for measuring force, pressure or mechanical tension} - A61B 2090/306: {using optical fibres} - A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body} - A61B 2090/378: {using ultrasound} - A61B 2090/3782: {transmitter or receiver in catheter or minimal invasive instrument} - A61B 2090/3784: {both receiver and transmitter being in the instrument or receiver being also transmitter} - A61B 2090/508: {with releasable brake mechanisms} - A61B 2217/005: with suction drainage system - A61B 2217/007: with irrigation system - A61B 2218/002: Irrigation - A61B 2218/007: Aspiration - A61M 25/04: in the body, e.g. expansible {(A61M25/10, A61M16/0488 take precedence)} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract 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. ## Claims ### Claim 1 A prostate resection apparatus comprising: a carrier having a proximal end and a distal end; at least one energy source on the carrier spaced proximally to be positioned in a urethra for delivering energy radially outwardly; and a processor comprising instructions configured: to provide a plurality of images of a tissue on a display visible to a user, each image of said plurality comprising a plane of a three-dimensional representation of the tissue; to receive input from the user to define a treatment profile along said each image of the plurality of images, the user input corresponding to an axial length of the treatment profile; and to determine a three-dimensional treatment profile based on the treatment profile along said each of the plurality of images. ### Claim 2 (depends on 1) An apparatus as in claim 1, wherein the processor comprises instructions to interpolate among treatment profiles of the plurality of images to determine the three-dimensional treatment profile. ### Claim 3 (depends on 2) An apparatus as in claim 2, wherein said instructions to interpolate among the treatment profiles of the plurality of images comprise using linear interpolation of splines to determine the three-dimensional treatment profile. ### Claim 4 (depends on 1) An apparatus as in claim 1, further comprising a non-pulsatile pump coupled to the carrier and an automated controller, wherein said automated controller is configured to control the pump to provide a pulsed energy delivery stream comprising a plurality of sequential pulses. ### Claim 5 (depends on 1) An apparatus as in claim 1, further comprising a pulsatile pump coupled to the carrier and an automated controller, wherein said pulsatile pump is configured to provide a pulsed energy delivery stream comprising a plurality of sequential pulses. ### Claim 6 (depends on 5) An apparatus as in claim 5, wherein the automated controller is configured to move the pulsed energy delivery stream such that the plurality of sequential pulses overlap at a target location of tissue to be removed. ### Claim 7 (depends on 5) An apparatus as in claim 5, wherein the automated controller is configured to move the pulsed energy delivery stream such that the plurality of sequential pulses do not overlap at a target location of tissue to be removed. ### Claim 8 (depends on 1) An apparatus as in claim 1, wherein an automated controller is configured to control movement of the at least one energy source based on a predetermined plan. ### Claim 9 (depends on 8) An apparatus as in claim 8, wherein the predetermined plan is input by the user based on pre-operative images of the prostate. ### Claim 10 (depends on 1) An apparatus as in claim 1, wherein an automated controller is configured to control movement of the at least one energy source based on real time assessment of the prostate obtained from an input device. ### Claim 11 (depends on 10) An apparatus as in claim 10, wherein the input device comprises an interstitial, laser guided imaging device. ### Claim 12 (depends on 10) An apparatus as in claim 10, wherein the input device comprises an interstitial sound guided differentiation detector. ### Claim 13 (depends on 10) An apparatus as in claim 10, wherein the automated controller further comprises a pulse width modulation device. ### Claim 14 (depends on 10) An apparatus as in claim 10, further comprising means for the user to override the automated controller. ### Claim 15 (depends on 1) An apparatus as in claim 1, wherein the three-dimensional treatment profile comprises a tissue removal profile of a predefined volume of tissue. ### Claim 16 (depends on 15) An apparatus as in claim 15, wherein the tissue removal profile of the predefined volume of tissue is shown on the plurality of images of the tissue of the prostate. ### Claim 17 (depends on 16) An apparatus as in claim 16, wherein the tissue removal profile shown on the plurality of images of the tissue of the prostate comprises dimensions scaled to the plurality of images of the prostate shown on the display such that dimensions of the tissue removal profile shown on the display correspond to dimensions of the plurality of images of the prostate shown on the display. ### Claim 18 (depends on 1) An apparatus as in claim 1, wherein the plurality of images comprise a plurality of sagittal views and a plurality of axial views showing different planes of the three-dimensional representation of the tissue. ### Claim 19 (depends on 18) An apparatus as in claim 18, wherein the treatment profile is defined by the user drawing the treatment profile on each of the plurality of sagittal views and on each of the plurality of axial views. ### Claim 20 (depends on 19) An apparatus as in claim 19, wherein the processor comprises instructions to interpolate among treatment profiles of the plurality of sagittal views and axial views to determine the three-dimensional treatment profile. ### Claim 21 (depends on 1) An apparatus as in claim 1, wherein the plurality of images comprises a plurality of surface points, and wherein the processor comprises instructions to determine the three-dimensional treatment profile based on polynomial fitting to the plurality of surface points. ### Claim 22 (depends on 1) An apparatus as in claim 1, wherein the user input treatment profile comprises a plurality of points on the plurality of images that are adjustable by the user to define the treatment profile. ### Claim 23 (depends on 22) An apparatus as in claim 22, wherein locations of the plurality of points are adjustable by the user on the display via a user interface. ### Claim 24 (depends on 23) An apparatus as in claim 23, wherein the user interface comprises a pointing device or a touch screen display. ### Claim 25 (depends on 22) An apparatus as in claim 22, wherein the processor comprises instructions to receive the plurality of points input by the user. ### Claim 26 (depends on 25) An apparatus as in claim 25, wherein the plurality of points are capable of being connected by the user using straight lines through linear interpolation or using curved lines corresponding to splines.