# US 2017/0319776 A1 · System and method for guided removal from an in vivo subject

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- Number: US 2017/0319776 A1
- Document ID: US20170319776A1
- Status: Published application
- Kind: A1
- Application number: 15/649,581
- Filed: 2017-07-13
- Published: 2017-11-09
- Earliest claimed: 2013-03-14
- Assignees: The General Hospital Corporation
- Applicants: The General Hospital Corporation; Kalera Medical, Inc.
- Inventors: Brian Howard Eisner; Darrin Kent; Steve Thompson; Matthew Yurek
- Web page: https://patentgrep.com/patent/US20170319776A1

## CPC

- A61M 3/0283: {with at least two inner passageways, a first one for irrigating and a second for evacuating (suction-irrigation systems A61M1/77; aspiration tips with fluid supply means A61M1/85; for negative pressure wound therapy A61M1/92)}
- A61B 1/00135: {Oversleeves mounted on the endoscope prior to insertion}
- A61B 1/00154: {using guiding arrangements for insertion}
- A61B 1/307: for the urinary organs, e.g. urethroscopes or cystoscopes
- A61B 17/22: Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B 17/3417: {Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating (syringe needles A61M5/32; dilators A61M29/00)}
- A61B 17/3421: {Cannulas}
- A61B 18/26: for producing a shock wave, e.g. laser lithotripsy
- A61M 1/77: {Suction-irrigation systems (aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463)}
- A61M 1/772: {operating alternately}
- A61M 1/85: {with gas or fluid supply means, e.g. for supplying rinsing fluids or anticoagulants (for negative pressure wound therapy A61M1/92, A61M1/94; combined with tracheal tubes A61M16/0463; dental instruments with combined rinsing and aspirating A61C17/0208)}
- A61M 3/0262: {manually, e.g. by squeezing a bulb}
- A61M 3/0295: {with inflatable balloon}
- A61M 25/09: Guide wires
- A61M 39/22: Valves or arrangement of valves {(A61M39/02, A61M39/0247, A61M39/16 take precedence; regulating valves in infusion systems A61M5/16881; in devices worn by the patient for the reception of urine, faeces, catamenial or other discharge, or in colostomy devices A61F5/4405)}
- A61B 2017/22079: {with suction of debris}
- A61B 2017/22084: {stone- or thrombus-dissolving}
- A61B 2017/3445: {used as instrument channel for multiple instruments}
- A61B 2018/00982: {combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes}
- A61B 2217/005: with suction drainage system
- A61B 2217/007: with irrigation system
- A61B 2218/002: Irrigation
- A61B 2218/007: Aspiration
- A61M 1/774: {Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently}
- A61M 3/0208: {before use}
- A61M 3/0216: {Pressure}
- A61M 3/022: {Volume; Flow rate}
- A61M 39/229: {Single-way cut-off valves}
- A61M 2210/1082: Kidney
- 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)}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

In accordance with some configurations, systems and methods for guided removal from an in vivo subject are provided. In some configurations, a method for removing an object is provided. The method comprising, guiding a flexible tube through a passageway of an in vivo subject, wherein the flexible tube comprises at least a first passageway and a second passageway. Positioning a distal end of the first passageway in proximity to the object. Infusing liquid through the second passageway substantially continuously. Removing the object through the first passageway with at least a portion of the liquid while suction is not being provided.

## Claims

### Claim 1

A method for removing an object, comprising:
guiding a flexible tube through a passageway of an in vivo subject, wherein the flexible tube comprises at least a first passageway and a second passageway;
positioning a distal end of the first passageway in proximity to the object;
infusing liquid through the second passageway substantially continuously; and
removing the object through the first passageway with at least a portion of the liquid while suction is not being provided.

### Claim 2 (depends on 1)

The method of claim 1, wherein the liquid is infused at a flow rate of at least about 5 milliliters per minute.

### Claim 3 (depends on 2)

The method of claim 2, further comprising:
coupling a bag containing liquid to the second passageway; and
increasing pressure on the bag to cause the liquid to be infused.

### Claim 4 (depends on 1)

The method of claim 1, wherein infusing the liquid comprises infusing the liquid through the second passageway for at least five minutes.

### Claim 5 (depends on 1)

The method of claim 1, further comprising:
causing suction to be provided at the distal end of the first passageway by a suction source coupled to the first passageway; and
removing another object through the first passageway with at least a second portion of the liquid while the suction is being provided

### Claim 6 (depends on 1)

The method of claim 1, further comprising:
inserting a sheath into the passageway of the vivo subject;
inserting a device through the sheath;
positioning the device adjacent to a second object;
using the device to break the second object into a plurality of objects including the object; and
wherein the flexible tube is guided through the sheath.

### Claim 7 (depends on 6)

The method of claim 6, wherein the flexible tube is guided through the sheath subsequent to removal of the device.

### Claim 8 (depends on 4)

The method of claim 4, wherein the second object is a kidney stone that has a diameter greater than about 10 millimeters and cannot be removed through the first passageway, and the object is a fragment of the kidney stone that has a diameter of less than about 4.33 millimeters.

### Claim 9 (depends on 1)

The method of claim 1, wherein the flexible tube has an external diameter of at least about 11 French.

### Claim 10

A method for removing an object, comprising:
inserting a sheath into an in vivo passageway of a subject;
inserting a device through the sheath;
positioning the device adjacent to the object;
using the device to break the object into a plurality of smaller objects;
removing the device;
guiding, subsequent to removal of the device, a flexible tube having an external diameter of at least about 11 French through the sheath, wherein the flexible tube comprises at least a first passageway and a second passageway;
positioning a distal end of the first passageway adjacent to the plurality of objects;
infusing saline solution through the second passageway while suction is off; and
removing the plurality of objects through the first passageway with at least a portion of the saline solution.