Direct vision cryosurgical probe and methods of use

A cryosurgical apparatus, comprising:

• an elongated structure having a distal end, a proximal end, and a lumen defined through the structure;
• an outer balloon positioned near or at the distal end, wherein the outer balloon is comprised of an optically transparent material;
• at least one imaging device adjustably positioned within the outer balloon;
• and
• at least one cryogenic probe positioned within the lumen such that one or more openings defined along the cryogenic probe are directed to a treatment region defined along an inner surface of the outer balloon;
• and
• at least one inner balloon positioned within the outer balloon such that inflation of the inner balloon expands the inner balloon into conformance against the inner surface of the outer balloon at a location opposite to the treatment region to thermally insulate areas adjacent to the treatment region.

A method for cryosurgical ablation of an anatomical structure in the body of a patient comprising the steps of:

• a. inserting a cryosurgical apparatus into the body of the patient, with said cryosurgical apparatus comprising an elongated structure with a distal end, a proximal end, a means for lateral tissue freezing disposed in the vicinity of the distal end, a means for lateral tissue thermal protection disposed in the vicinity of the distal end in diametric opposition to said lateral freezing means, an imaging device mounted in the vicinity of the distal end configured for distal imaging, a means for connecting the lateral freezing means to a source of cryogenic fluid, and a means for connecting the imaging device to an imaging console disposed in the vicinity of the proximal end;
• b. advancing said distal end into close proximity of the target anatomical structure;
• c. imaging distal tissue with said imaging device, and using said imaging to orient the lateral freezing means adjacent to the target anatomical structure;
• d. freezing the anatomical structure with said lateral freezing means,
• whereby said lateral tissue thermal protection means prevents cryogenic injury to tissue adjacent to the target anatomical structure.

A cryosurgical apparatus comprising:

• a. an elongated rigid structure with a distal end, a proximal end, and a central lumen;
• b. a non-coring optically transparent needle tip located at the distal end and having at least one lateral fenestration in communication with the central lumen, and housing at least one imaging device configured for distal imaging;
• c. a handle located at the proximal end and having a means for connecting the imaging device(s) to an imaging display(s);
• and
• d. a means for accessing bodily tissue in the vicinity of the distal end with a cryo-ablation probe through the central lumen and the lateral fenestration(s).

A cryosurgical apparatus comprising:

• a. an elongated structure with a distal end, a proximal end, and at least one central lumen;
• b. an inflatable balloon structure located at the distal end and configured as a refrigerant evaporation chamber, and as an optical imaging window, enclosing at least one optical imaging device;
• c. an introducing means located at the proximal end for introducing a liquid refrigerant into the distal balloon through a central lumen;
• d. a removal means located at the proximal end for removing evaporated refrigerant from the cryosurgical apparatus at a predetermined pressure;
• e. a connecting means located at the proximal end for connecting the optical imaging device(s) to an imaging display;
• f. an inflation means located at the proximal end for inflating the balloon with a liquid or a gas;
• and
• g. a spraying means located at the proximal end for spraying liquid refrigerant at a lateral interior portion of the balloon for the purpose of lateral tissue freezing.

A cryosurgical apparatus comprising:

• a. an elongated structure with a distal end, a proximal end, and at least one central lumen,
• b. an outer inflatable balloon structure located at the distal end and configured as an optical imaging window, and as a tissue dilator enclosing at least one optical imaging device, at least one inner cryogenic evaporator balloon, and at least one inner thermal insulation balloon;
• c. an introducing means located at the proximal end for introducing a liquid refrigerant into the inner cryogenic evaporator balloon through a central lumen, a means of removing evaporated refrigerant from the cryogenic evaporator balloon through a central lumen at a predetermined pressure, a means for inflating the thermal insulation balloon with the pressurized evaporated refrigerant gas, a means for connecting the optical imaging device(s) to an imaging display, and a means for inflating the outer balloon with a liquid or a gas;
• and
• d. a spraying means located at the proximal end for spraying liquid refrigerant at a lateral interior portion of the inner cryogenic evaporator balloon for the purpose of lateral tissue freezing.