# US 11,464,536 B2 · Automated image-guided tissue resection and treatment

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- Number: US 11,464,536 B2
- Document ID: US11464536B2
- Status: Granted
- Kind: B2
- Application number: 16/894,130
- Filed: 2020-06-05
- Published: 2020-10-22
- Granted: 2022-10-11
- Earliest claimed: 2012-02-29
- Assignees: PROCEPT BioRobotics Corporation
- Applicants: PROCEPT BioRobotics Corporation
- Inventors: Nikolai Aljuri; Surag Mantri; George Surjan; Michael W. Sasnett; Jonathan Foote
- Web page: https://patentgrep.com/patent/US11464536B2

## 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 medical method, comprising:
providing a water jet system, wherein the water jet system comprises a water jet fluid flush tube and a removal port;
endoscopically inserting the water jet system into a patient;
utilizing a visualization element separate from the water jet system to visualize a treatment performed by the water jet system;
applying fluid from the water jet flush tube at a first flow rate to create a cutting jet area to resect tissue;
robotically controlling cutting motion by the water jet fluid flush tube to resect the tissue;
controlling, based on feedback, a flow rate of the fluid from the water jet flush tube by adjusting the flow rate from the first flow rate to a second flow rate to resect target tissue at the second flow rate while leaving non-target tissue substantially undamaged, the feedback including an ultrasound image showing an effect of the fluid from the water jet flush tube on the tissue; and
using the removal port to remove resected tissue via aspiration.

### Claim 2 (depends on 1)

The medical method of claim 1, further comprising attaching the water jet system to an arm.

### Claim 3 (depends on 2)

The medical method of claim 2, wherein the arm is a robotic arm, and wherein the robotic arm is coupled to the water jet system via an instrument driver.

### Claim 4 (depends on 1)

The medical method of claim 1, wherein the fluid comprises a saline solution.

### Claim 5 (depends on 1)

The medical method of claim 1, wherein the water jet system comprises a central processing unit for controlling aspiration via the removal port.

### Claim 6 (depends on 1)

The medical method of claim 1, wherein the applying fluid includes modulating a flow of the fluid.

### Claim 7 (depends on 1)

The medical method of claim 1, wherein the removal port is coupled to an aspiration source via a tube, a portion of the water jet fluid flush tube and a portion of the tube being co-axially disposed relative to each other.

### Claim 8 (depends on 1)

The medical method of claim 1, wherein the cutting motion includes a predefined shape.

### Claim 9 (depends on 1)

The medical method of claim 1, wherein the visualization element includes an ultrasound element.

### Claim 10 (depends on 1)

The medical method of claim 1, further comprising maintaining a pressure of fluid delivered from an insufflation port of the water jet system within a desired range based on feedback from a pressure sensor.

### Claim 11 (depends on 1)

The medical method of claim 1, wherein the robotically controlling cutting motion includes robotically controlling movement of the water jet fluid flush tube relative to the target tissue based on a shape of the target tissue.