Brachytherapy apparatus and method for use with minimally invasive surgeries of the lung

Abstract

Brachytherapy treatment of a patient's lung tissue following resection is effected using a balloon applicator which is inserted, normally through the same opening used for the surgery, through the chest wall and into the cavity. The lung and chest openings are closed around the applicator and generally sealed around the applicator. A suction port is provided, in a suction circuit of the applicator, to withdraw fluid from the pleural cavity, at intervals as needed, to assure that the lung can be inflated. Different embodiments of suction circuits are disclosed. A bronchial applicator and method are also disclosed.

What is claimed is: 
     
         1 . An applicator adapted for brachytherapy treatment in a human lung of a patient, comprising:
 a shaft having a proximal end and a distal end and defining an elongated internal channel;   an inflatable balloon secured to the distal end of the shaft;   a catheter carrying a source of ionizing radiation at or near the distal end of the catheter;   the shaft elongated internal channel receiving the catheter and radiation source;   a hub disposed at the proximal end of the shaft through which the catheter is inserted;   the hub including an inflation port for inflating the balloon through the shaft;   a suction sleeve having a proximal end and a distal end;   the suction sleeve being disposed coaxially about the shaft, being constructed and arranged for sliding motion on the shaft between withdrawn and advanced positions thereof, and defining a suction channel extending in a direction between proximal and distal ends thereof and about the shaft;   a suction port at and in communication with the suction sleeve;   the suction sleeve having the distal end thereof open for communication with a body cavity in the advanced position thereof.   
     
     
         2 . The applicator of  claim 1  wherein the suction sleeve is tubular. 
     
     
         3 . The applicator of  claim 2  wherein the distal end of the tubular suction sleeve is open to form an annular coupling port to the body cavity. 
     
     
         4 . The applicator of  claim 1  wherein the suction sleeve has a fluid tight seal at the proximal end thereof. 
     
     
         5 . The applicator of  claim 4  wherein the proximal end of the suction sleeve is enlarged and the seal comprises an o-ring seal disposed at the enlarged end. 
     
     
         6 . The applicator of  claim 4  wherein the suction port of the suction sleeve extends radially of the suction sleeve. 
     
     
         7 . The applicator of  claim 1  wherein the shaft extends across the full diameter of the balloon. 
     
     
         8 . The applicator of  claim 1  wherein the suction sleeve is disposed proximal to the inflatable balloon, and the shaft has a distal most end that is in contact with the balloon. 
     
     
         9 . The applicator of  claim 1  including a knob at the proximal end of the suction sleeve, and wherein the shaft is attached at opposed sides of the balloon. 
     
     
         10 . An applicator adapted for brachytherapy treatment in a human lung, comprising:
 a shaft with an inflatable balloon secured to its distal end, the shaft defining an internal channel adapted to receive a catheter carrying a source of ionizing radiation near the distal end of the catheter;   the shaft including, at a proximal end thereof, a hub through which the catheter can be inserted, and the hub including provision for inflating the balloon through the shaft;   a suction port positioned to communicate via a suction circuit with the pleural cavity of the patient to drain or evacuate fluid; and   the suction circuit including a slidable sleeve having a distal end thereof forming the suction port, adjustable as to axial position about and along the shaft, with the suction port positionable at a body cavity, and an evacuation port positioned on the sleeve to be exterior of the body cavity.   
     
     
         11 . The applicator of  claim 10  wherein the distal end of the suction sleeve is open to form an annular coupling port to the body cavity. 
     
     
         12 . The applicator of  claim 10  wherein the suction sleeve has a fluid tight seal at the proximal end thereof, and a knob for manipulating the sleeve. 
     
     
         13 . The applicator of  claim 10  wherein the shaft extends across the full diameter of the balloon. 
     
     
         14 . The applicator of  claim 10  wherein the suction sleeve is disposed proximal to the inflatable balloon, and the shaft has a distal most end that is in contact with the balloon. 
     
     
         15 . The applicator of  claim 10  including a knob at the proximal end of the suction sleeve, and wherein the shaft is attached at opposed sides of the balloon. 
     
     
         16 . A method for brachytherapy treatment in a human lung, comprising:
 extending an applicator through the skin into the lung tissue and into a resection cavity, said applicator having an inflatable balloon at its distal end, the balloon being deflated upon insertion,   the applicator having a shaft supporting the balloon, and defining an internal channel adapted to receive a catheter carrying a source of ionizing radiation near the distal end of the catheter, and the shaft including at a proximal end a hub through which the catheter can be inserted, and the hub including provision for inflating the balloon through the shaft,   inflating the balloon within the resection cavity,   irradiating tissue within the lung and adjacent to the resection cavity by means of the source carried by the catheter within the inflated balloon;   providing a suction sleeve about the shaft including positioning the suction sleeve so that a distal end thereof is in communication with a pleural cavity of the patient to drain or evacuate fluid; and   at least partially withdrawing the applicator after being inserted.   
     
     
         17 . The method of  claim 16  including providing the suction sleeve as slideable along the shaft between withdrawn and advanced positions. 
     
     
         18 . The method of  claim 17  including providing the distal end of the suction sleeve as open to define a suction port. 
     
     
         19 . The method of  claim 18  further including sliding the suction sleeve so that the suction port is in communication with the body cavity. 
     
     
         20 . The method of  claim 19  including providing a knob on the suction sleeve to assist in sliding the suction sleeve.