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end of the catheter;   the shaft elongated internal channel receiving the catheter and radiation source and having withdrawn and advanced positions;   a hub disposed at the proximal end of the shaft through which the catheter is inserted;   the hub including an inflation port for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 port;   the shaft channel separated into an inflation channel in communication between the inflation port at the hub and the balloon, and a suction channel having a coupling port;   the suction channel being in communication between the suction port and coupling port for providing communication with a body cavity in the advanced position.   
     
     
         2 . The applicator of  claim 1  wherein, in the advanced position, the catheter extends beyond the distal end of the shaft. 
     
     
         3 . The applicator of  claim 1  wherein the inflation channel and suction channel extend in juxtaposition the length of the shaft channel. 
     
     
         4 . The applicator of  claim 3  including a seal disposed at the distal end of the suction channel. 
     
     
         5 . The applicator of  claim 1  including a seal disposed at the distal end of the suction channel. 
     
     
         6 . The applicator of  claim 1  wherein the shaft channel is cylindrical and includes a dividing wall therein that, with the cylindrical shaft, defines the separate inflation and suction channels. 
     
     
         7 . The applicator of  claim 6  wherein the inflation channel is larger in cross-section than the suction channel. 
     
     
         8 . The applicator of  claim 1  wherein the coupling port is directly in communication with the suction channel. 
     
     
         9 . The applicator of  claim 8  wherein the inflation channel and suction channel extend in juxtaposition the length of the shaft channel. 
     
     
         10 . The applicator of  claim 9  including a seal disposed at the distal end of the suction channel. 
     
     
         11 . The applicator of  claim 10  wherein the shaft channel is cylindrical and includes a dividing wall therein that, with the cylindrical shaft, defines the separate inflation and suction channels. 
     
     
         12 . 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 coupling port positioned to communicate via a suction circuit with the pleural cavity of the patient to drain or evacuate fluid; and   the shaft including a separate channels disposed within the shaft and including an inflation channel for communicating between the hub and balloon and a suction channel forming part of the suction circuit for communicating between the hub and suction coupling port, the shaft being positionable to enable communication of the suction coupling port with the pleural cavity.   
     
     
         13 . The applicator of  claim 12  wherein, in the advanced position, the catheter extends beyond the distal end of the shaft. 
     
     
         14 . The applicator of  claim 12  wherein the inflation channel and suction channel extend in juxtaposition the length of the shaft channel. 
     
     
         15 . The applicator of  claim 14  including a seal disposed at the distal end of the suction channel. 
     
     
         16 . The applicator of  claim 15  wherein the shaft channel is cylindrical and includes a dividing wall therein that, with the cylindrical shaft, defines the separate inflation and suction channels. 
     
     
         17 . 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 the shaft in separate channels disposed within the shaft and including an inflation channel for communicating between the hub and balloon and a suction channel for communicating between the hub and suction coupling port, the shaft being positionable to enable communication of the suction coupling port with the pleural cavity;   at least partially withdrawing the applicator after being inserted.   
     
     
         18 . The method of  claim 17  including extending the catheter beyond the distal end of the shaft. 
     
     
         19 . The method of  claim 17  wherein, once the balloon is positioned in the cavity, the axial location of the pleural cavity is marked on the shaft over the suction channel. 
     
     
         20 . The method of  claim 19  further including withdrawing the applicator and forming the coupling port at the marked location.