Open system heat exchange catheters and methods of use

Abstract

Various embodiments of open system heat exchange catheters and methods of use are disclosed. The various catheters can be used with various ablative surgical devices. One specific exemplary use is in conjunction with cryosurgical probes involving ablation of the prostate, in which the integrity of the urethra is desired to be maintained. Other uses involve various heating ablative devices. In one embodiment an injection tube assembly is used to provide heat exchange fluid through the urethra to the bladder where it is then expelled via a suprapubic suction tube. In other embodiments a coaxial tube assembly is utilized which defines a passageway for either expelling the bladder fluid or for providing access to an endoscope. In other embodiments a double lumen assembly is utilized that defines a passageway for expelling bladder fluid.

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       6 . A method for warming the urethra of a patient during ablative surgery, comprising the steps of: 
 a) inserting at least one ablative surgical device into a prostate region of the patient;    b) inserting an injection tube assembly through the patient's urethra and into the bladder;    c) delivering warming fluid through a first section of said injection tube assembly during operation of said at least one ablative surgical device, said warming fluid being delivered into the bladder; and,    f) operating a second section of said injection tube assembly to expel bladder fluid from the bladder during said delivering of warming fluid through said injection tube assembly, said bladder fluid including said warming fluid,    wherein said urethra is warmed by said warming fluid to preserve living tissue thereof.    
   
   
       7 . The method of  claim 6 , wherein said step of inserting an injection tube assembly comprises inserting a co-axial tube assembly, said co-axial tube assembly comprising: 
 a) an inlet comprising a single tube;    b) a coaxial portion, comprising: 
 i) an inner coaxial tube; and  
 ii) an outer coaxial tube, said inner coaxial tube and outer coaxial tube being coaxial, said outer coaxial tube being in fluid communication with said inlet and for discharging said warming fluid into the bladder, said inner coaxial tube for introducing bladder fluid from said bladder;  
   c) an outlet comprising a single tube, said outlet being in fluid communication with said inner tube; and,    d) a connector for connecting said inlet, said coaxial portion and said outlet,    wherein during use, warming fluid is delivered through said inlet, through said outer coaxial tube thus warming said urethra, discharged to the bladder, and mixed with bladder fluid, and wherein bladder fluid is directed through said inner coaxial tube and through said outlet.    
   
   
       8 . The method of  claim 6 , wherein said step of inserting an injection tube assembly comprises inserting a double lumen tube assembly, said double lumen tube assembly comprising: 
 a) an inlet comprising a single tube;    b) a double lumen portion, comprising: 
 i) a first fluid passageway; and  
 ii) a second fluid passageway,  
 said first fluid passageway being in fluid communication with said inlet and for discharging said warming fluid into the bladder, said second fluid passageway for introducing bladder fluid from said bladder;  
   c) an outlet comprising a single tube, said outlet being in communication with said second fluid passageway,    wherein during use, warming fluid is delivered through said inlet, through said first fluid passageway thus warming said urethra, discharged to the bladder, and mixed with bladder fluid, and wherein bladder fluid is directed through said second passageway and through said outlet.    
   
   
       9 . A method for warming the urethra of a patient during ablative surgery, comprising the steps of: 
 a) inserting a suprapubic suction tube into the bladder of a patient;    b) inserting at least one ablative surgical device into a prostate region of the patient;    c) inserting an injection tube assembly through the patient's urethra and into the bladder, said injection tube assembly comprising: 
 i. a warming fluid inlet comprising a single tube;  
 ii. a coaxial portion comprising: 
 1. an inner coaxial tube; and  
 2. an outer coaxial tube, said inner coaxial tube and outer coaxial tube being coaxial,  
 said outer coaxial tube being in fluid communication with said warming fluid inlet and for discharging said warming fluid into the bladder, said inner coaxial tube for retaining a distal portion of an endoscope;  
 
 iii) an endoscope inlet comprising a single tube, said endoscope inlet for containing a proximal portion of an endoscope; and,  
 iv) a connector for connecting said warming fluid inlet, said coaxial portion and said endoscope inlet;  
   d) delivering warming fluid through said inlet of said injection tube assembly during operation of said at least one ablative surgical device, said warming fluid being delivered into the bladder; and,    e) operating said suction tube to expel bladder fluid from the bladder during said delivering of warming fluid through said injection tub assembly, said bladder fluid including said warming fluid,    wherein said urethra is warmed by said warming fluid to preserve living tissue thereof.    
   
   
       10 . The method of  claim 9 , further comprising the step of inserting an endoscope into said endoscope inlet.  
   
   
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       16 . A method for cooling the urethra of a patient during ablative surgery, comprising the steps of: 
 a) inserting at least one ablative surgical device into a prostate region of the patient;    b) inserting an injection tube assembly through the patient's urethra and into the bladder;    c) delivering cooling fluid through a first section of said injection tube assembly during operation of said at least one ablative surgical device, said cooling fluid being delivered into the bladder; and,    d) operating a second section of said injection tube assembly to expel bladder fluid from the bladder during said delivering of cooling fluid through said injection tube assembly, said bladder fluid including said cooling fluid,    wherein said urethra is warmed by said cooling fluid to preserve living tissue thereof.    
   
   
       17 . The method of  claim 16 , wherein said step of inserting an injection tube assembly comprises inserting a co-axial tube assembly, said co-axial tube assembly comprising: 
 a) an inlet comprising a single tube;    b) a coaxial portion comprising: 
 a. an inner coaxial tube; and  
 b. an outer coaxial tube, said inner coaxial tube and outer coaxial tube being coaxial, said outer coaxial tube being in fluid communication with said inlet and for discharging said cooling fluid into the bladder, said inner coaxial tube for introducing bladder fluid from said bladder;  
   c) an outlet comprising a single tube, said outlet being in fluid communication with said inner tube; and,    d) a connector for connecting said inlet, said coaxial portion and said outlet,    wherein during use, cooling fluid is delivered through said inlet, through said outer coaxial tube thus cooling said urethra, discharged to the bladder, and mixed with bladder fluid, and wherein bladder fluid is directed through said inner coaxial tube and through said outlet.    
   
   
       18 . The method of  claim 16 , wherein said step of inserting an injection tube assembly comprises inserting a double lumen tube assembly, said double lumen tube assembly comprising: 
 a) an inlet comprising a single tube;    b) a double lumen portion, comprising: 
 i) a first fluid passageway; and  
 ii) a second fluid passageway,  
 said first fluid passageway being in fluid communication with said inlet and for discharging said cooling fluid into the bladder, said second fluid passageway for introducing bladder fluid from said bladder;  
   c) an outlet comprising a single tube, said outlet being in communication with said second fluid passageway,    wherein during use, cooling fluid is delivered through said inlet, through said first fluid passageway thus cooling said urethra, discharged to the bladder, and mixed with bladder fluid, and wherein bladder fluid is directed through said second passageway and through said outlet.    
   
   
       19 . A method for cooling the urethra of a patient during ablative surgery, comprising the steps of: 
 a) inserting a suprapubic suction tube into the bladder of a patient;    b) inserting at least one ablative surgical device into a prostate region of the patient;    c) inserting an injection tube assembly through the patient's urethra and into the bladder, said injection tube assembly comprising: 
 i. a cooling fluid inlet comprising a single tube;  
 ii. a coaxial portion comprising: 
 1. an inner coaxial tube; and,  
 2. an outer coaxial tube, said inner coaxial tube and outer coaxial tube being coaxial,  
 said outer coaxial tube being in fluid communication with said cooling fluid inlet and for discharging said cooling fluid into the bladder, said inner coaxial tube for retaining a distal portion of an endoscope; and,  
 
 iii. an endoscope inlet comprising a single tube, said endoscope inlet for containing a proximal portion of an endoscope; and,  
 iii. a connector for connecting said cooling fluid inlet, said coaxial portion and said endoscope inlet;  
   d) delivering cooling fluid through said inlet of said injection tube assembly during operation of said at least one ablative surgical device, said cooling fluid being delivered into the bladder; and,    e) operating said suction tube to expel bladder fluid from the bladder during said delivering of cooling fluid through said injection tub assembly, said bladder fluid including said cooling fluid,    wherein said urethra is cooled by said cooling fluid to preserve living tissue thereof.    
   
   
       20 . The method of  claim 19 , further comprising the step of inserting an endoscope into said endoscope inlet.  
   
   
       21 . A heat exchange catheter for maintaining a suitable temperature of the urethra of a patient during ablative surgery, comprising: 
 an injection tube assembly, comprising:    a) an inlet comprising a single tube for providing the introduction of a heat exchange fluid;    b) a coaxial portion, comprising: 
 i) an inner coaxial tube; and  
 ii) an outer coaxial tube, said inner coaxial tube and outer coaxial tube being coaxial,  
 said outer coaxial tube being in fluid communication with said inlet and for discharging the heat exchange fluid into the bladder, said inner coaxial tube for introducing bladder fluid from said bladder;  
   c) an outlet comprising a single tube, said outlet being in fluid communication with said inner tube; and,    d) a connector for connecting said inlet, said coaxial portion and said outlet,    wherein during use, heat exchange fluid is delivered through said inlet, through said outer coaxial tube thus providing heat transfer with said urethra, discharged to the bladder, and mixed with bladder fluid, and wherein bladder fluid is directed through said inner coaxial tube and through said outlet.    
   
   
       22 . A heat exchange catheter for maintaining a suitable temperature of the urethra of a patient during ablative surgery, comprising: 
 an injection tube assembly, comprising:    a) a heat exchange fluid inlet comprising a single tube;    b) a coaxial portion comprising: 
 a. an inner coaxial tube; and,  
 b. an outer coaxial tube, said inner coaxial tube and outer coaxial tube being coaxial, said outer coaxial tube being in fluid communication with said heat exchange fluid inlet and for discharging said heat exchange fluid into the bladder, said inner coaxial tube for retaining a distal portion of an endoscope;  
   c) an endoscope inlet comprising a single tube, said endoscope inlet for containing a proximal portion of an endoscope; and,    d) a connector for connecting said heat exchange fluid inlet, said coaxial portion and said endoscope inlet,    wherein during use, heat exchange fluid is delivered through said heat exchange fluid inlet, through said outer coaxial tube, and into the bladder.    
   
   
       23 . A heat exchange catheter for maintaining a suitable temperature of the urethra of a patient during ablative surgery, comprising: 
 a double lumen tube assembly, comprising:    a) an inlet comprising a single tube;    b) a double lumen portion, comprising: 
 a first fluid passageway; and  
 a second fluid passageway,  
 said first fluid passageway being in fluid communication with said inlet and for discharging heat exchange fluid into the bladder, said second fluid passageway for introducing bladder fluid from said bladder;  
   c) an outlet comprising a single tube, said outlet being in communication with said second fluid passageway, 
 wherein during use, heat exchange fluid is delivered through said inlet, through said first fluid passageway thus providing heat transfer with said urethra, discharged to the bladder, and mixed with bladder fluid, and wherein bladder fluid is directed through said second passageway and through said outlet.