# US 2013/0253484 A1 · Multi-Fluid Tissue Ablation Methods for Treatment of an Organ > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2013/0253484 A1 - Document ID: US20130253484A1 - Status: Published application - Kind: A1 - Application number: 13/792,780 - Filed: 2013-03-11 - Published: 2013-09-26 - Earliest claimed: 2007-01-02 - Assignees: AquaBeam, LLC - Applicants: Aquabeam, LLC - Inventors: Nikolai ALJURI - Web page: https://patentgrep.com/patent/US20130253484A1 ## CPC - A61B 17/3203: Fluid jet cutting instruments - 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 18/14: Probes or electrodes therefor - A61B 18/1485: {having a short rigid shaft for accessing the inner body through natural openings} - A61B 18/18: by applying electromagnetic radiation, e.g. microwaves - A61B 18/201: {with beam delivery through a hollow tube, e.g. forming an articulated arm (through a flexible conduit A61B18/22); Hand-pieces therefor} - A61B 18/24: with a catheter (A61B18/26, A61B18/28 take precedence) - A61F 9/007: Methods or devices for eye surgery - A61F 9/00736: {Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments (A61F9/008 takes precedence)} - A61B 2017/00274: {Prostate operation, e.g. prostatectomy, turp, bhp treatment} - A61B 2017/22079: {with suction of debris} - A61B 2018/00196: {reciprocating lengthwise} - A61B 2018/00285: {Balloons} - A61B 2018/00547: {Prostate} - A61B 2018/00577: {Ablation} - A61B 2018/00583: {Coblation, i.e. ablation using a cold plasma} - A61B 2018/00946: {slidable} - A61B 2018/00952: {rotatable} - A61B 2018/046: {in liquid form} - A61B 2018/1472: {for use with liquid electrolyte, e.g. virtual electrodes} - A61B 2018/1497: {Electrodes covering only part of the probe circumference} - A61B 2018/1861: {with an instrument inserted into a body lumen or cavity, e.g. a catheter} - A61B 2218/002: Irrigation - A61B 2218/007: Aspiration - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) ## Abstract Prostate treatment using fluid stream to resect prostate tissue, thereby relieving symptoms of conditions such as BPH, prostatitis, and prostatic carcinoma. A device having a fluid delivery element is positioned within a lumen of the urethra within the prostate. A fluid stream is directed outwardly from the fluid delivery element toward a wall of the urethral lumen. The fluid delivery element is moved to scan the fluid stream over the wall to remove a volume of tissue surrounding the lumen. The fluid may be combined with therapeutically active substances or with substances that increase resection efficiency. Fluid force may be adjusted to provide selective tissue resection such that soft tissue is removed while harder tissue is left undamaged. In order to gain a working space within the urethra, another fluid may be introduced to insufflate the urethra in the region of treatment. ## Claims ### Claim 1 A method for tissue modification, comprising: inserting a probe into an organ; delivering a first fluid into the organ to create a working space; delivering a second fluid through the probe as a fluid stream to the tissue, wherein the second fluid is different from the first fluid; and resecting a volume of the tissue using the fluid stream. ### Claim 2 (depends on 1) The method of claim 1, wherein the tissue comprises tissue of an eye. ### Claim 3 (depends on 1) The method of claim 1, wherein the stream is released with a pressure configured to remove a first tissue and inhibit removal of a second tissue connected to the first tissue, the first tissue comprising a conglomerate of tissue cells, the second tissue comprising one or more of blood vessels, stroma, connective tissue or capsular tissue. ### Claim 4 (depends on 1) The method of claim 1, further comprising: selecting one or more fluid stream parameters such that the resecting is selective to a particular tissue type, wherein the parameters are fluid stream shape and fluid stream source pressure. ### Claim 5 (depends on 4) The method of claim 4, wherein the tissue comprises a first tissue and a second tissue, the first tissue comprising a first critical pressure, the second tissue comprising a second critical pressure and wherein the second fluid is released with an amount pressure greater than the first critical pressure in order to inhibit removal of the second tissue when the first tissue is resected. ### Claim 6 (depends on 1) The method of claim 1, further comprising delivering a sufficient amount of the first fluid to create a volume of the first fluid within the working space, such that the fluid stream travels through the volume of the first fluid. ### Claim 7 (depends on 6) The method of claim 6, wherein the first fluid is a gas and the second fluid is a liquid. ### Claim 8 (depends on 7) The method of claim 7, further comprising directing the first fluid towards the fluid stream, thereby allowing the first fluid to envelope the fluid stream to preserve a stream integrity of the fluid stream. ### Claim 9 (depends on 7) The method of claim 7, wherein the second fluid is delivered at a force sufficient to resect tissue. ### Claim 10 (depends on 1) The method of claim 1, further comprising using a visualization element in the working space. ### Claim 11 (depends on 1) The method of claim 1, further comprising transmitting energy through an interior of the fluid stream to cauterize the tissue. ### Claim 12 (depends on 11) The method of claim 11, wherein the energy is sufficient to resect the tissue. ### Claim 13 (depends on 11) The method of claim 11, further comprising adjusting the delivery of the second fluid such that the fluid stream transmits energy but does not resect tissue. ### Claim 14 (depends on 11) The method of claim 11, wherein the energy is electromagnetic energy. ### Claim 15 (depends on 14) The method of claim 14, wherein the electromagnetic energy is radiofrequency energy. ### Claim 16 (depends on 14) The method of claim 14, wherein the electromagnetic energy is light. ### Claim 17 (depends on 11) The method of claim 11, wherein the first fluid and the second fluid are selected such that a difference between their refractive indices causes the fluid stream to operate as an optical conduit. ### Claim 18 (depends on 1) The method of claim 1, further comprising removing a mixture of resected tissue and the second fluid from the working space. ### Claim 19 The method of 18, wherein the removing comprises generating a pressure differential between an outlet for the first fluid and an inlet for the mixture. ### Claim 20 A method for tissue modification, comprising: inserting a probe into an organ; creating a working space within the organ; delivering a fluid through the probe as a fluid stream to the tissue; and resecting a volume of the tissue using the fluid stream. ### Claim 21 (depends on 20) The method of claim 20, wherein the organ comprises an eye. ### Claim 22 A method for modifying tissue, comprising: positioning a device into the tissue, wherein the device comprises a fluid delivery element configured to deliver a fluid stream from the device towards the tissue; and resecting a volume of the tissue by delivering the fluid stream to the tissue. ### Claim 23 (depends on 22) The method of claim 22, wherein the tissue comprises tissue of an eye. ### Claim 24 (depends on 22) The method of claim 22, further comprising delivering the fluid stream outwardly at an angle with respect to a longitudinal axis of the device and towards the tissue. ### Claim 25 (depends on 22) The method of claim 22, further comprising setting one or more fluid stream parameters such that the resecting is selective to a particular tissue type, wherein the parameters are fluid stream shape and fluid stream source pressure. ### Claim 26 (depends on 25) The method of claim 25, wherein the parameters are set such that the fluid stream selectively resects a first tissue while leaving a second tissue substantially undamaged. ### Claim 27 (depends on 25) The method of claim 25, wherein the first tissue comprising a conglomerate of tissue cells and the second tissue comprises one or more of blood vessels, stroma, connective tissue or capsular tissue. ### Claim 28 (depends on 27) The method of claim 27, wherein the second tissue comprises the capsular tissue and the first tissue comprises tissue contained within the capsule. ### Claim 29 (depends on 28) The method of claim 28, wherein the fluid stream shape is columnar and released with a pressure within a range to remove the first tissue contained within the capsule and spare the capsule from removal. ### Claim 30 (depends on 28) The method of claim 28, wherein the fluid stream comprises a divergent fluid stream released from a fluid delivery element placed within the capsule and wherein the fluid delivery element is inserted into the capsule such that the fluid stream diverges from the element toward the capsule to remove the first tissue contained within the capsule and spare the capsule from removal. ### Claim 31 (depends on 28) The method of claim 28, wherein the fluid stream is delivered with a force sufficient to resect the first tissue and spare resection of the second tissue. ### Claim 32 (depends on 28) The method of claim 28, wherein an elongate element having a proximal end and a distal end is inserted into the organ and wherein the fluid delivery element translates, rotates, oscillates, or rotationally oscillates relative to an elongate element.