Biopsy needle insertion guide and method of use in prostate cryosurgery

A biopsy needle insertion guide for use with an elongated ultrasound probe insertable into body orifices in medical procedures the guide comprising:

• (a) a first body having a first portion with a semicircular cut-out therein forming a first clamp member and a second elongated portion extending from said first portion opposite said cutout, said second portion having a longitudinal slot therein;
• (b) a second body forming a second clamp member hingeably connected to said first portion of said first body and having a semicircular cut-out therein whereby, when said second body is brought into mating engagement with said first portion of said first body, said semicircular cut-outs cooperate thereby forming a through channel in which said ultrasound probe is receivable, said through channel having a longitudinal axis perpendicular to said longitudinal slot;
• (c) hinge means connecting said second body to said first portion of said first body and latch means to latch said second body and said first portion of said first body in a clamping arrangement about said ultrasound probe;
• (d) a third body slidable within said slot in said second portion of said first body;
• and
• (e) a needle guide assembly adjustably carried by said slidable third body and comprising an elongated shaft extendable through said slidable third body in a direction parallel to the longitudinal axis of said clamp through channel, a needle holder on a first end of said shaft and a biasing spring connected between said slideable third body and a second end of said shaft;
• whereby said clamp members cooperate to removably and rigidly mount said insertion guide onto said ultrasound probe whereby said elongated shaft is parallel to the longitudinal axis of said probe, said elongated portion of said first body extends in a direction perpendicular to the longitudinal axis of said probe such that said third body is slidable along said elongated portion toward and away from said probe, and said needle guide assembly is slidable parallel to said probe whereby a biopsy needle held by said needle holder is variably positionable for entry into a body at positions radially located relative to said probe.

A method for accurate placement of cryoprobes into a human prostate during prostate cryosurgery wherein a rectally inserted elongated ultrasound probe is employed for imaging the prostate, the method comprising the steps of:

• (a) providing a biopsy needle insertion guide removably mountable to said ultrasound probe and comprising a clamp for mounting said guide to said probe, an elongated adjustment guide extending from said clamp in a direction perpendicular to said probe, a slide block engaging said adjustment guide and slidably adjustable therealong, and a biopsy needle holder and guide assembly carried by said slide block and extendable therefrom in a direction parallel to said probe;
• (b) mounting said biopsy needle insertion guide on said ultrasonic probe whereby said probe is insertable into a patient's rectum and said biopsy needle holder and guide is extendable toward a proximal end of said probe to engage patient's perineum;
• (c) inserting said probe into a patient's rectum and activating ultrasound imaging means whereby said prostate is imaged;
• (d) adjusting said slide block along said adjustment guide to a position relative to said probe corresponding to a desired needle insertion point as determined from the ultrasound image of said prostate;
• (e) advancing said probe and insert guide proximally to engage the patient's perineum with said biopsy needle and holder;
• (f) inserting a biopsy needle through said needle guide and holder into said prostate;
• (g) inserting a guide wire through said needle;
• (h) removing said needle and insertion guide while leaving said ultrasound probe and guide wire in place;
• (i) inserting a cryoprobe sheath over said guide wire followed by removal of said guide wire;
• and
• (j) inserting a cryoprobe through said sheath into said prostate;
• whereby said cryoprobe is accurately positioned in said prostate and is activated to freeze said prostate.