Methods for biofilm removal

Patent metadata

Field	Value
Publication number	US-9339172-B2
Application number	US-88621510-A
Country	US
Kind code	B2
Filing date	Sep 20, 2010
Priority date	Jan 9, 2007
Publication date	May 17, 2016
Grant date	May 17, 2016

Abstract

A method of removing bacterial biofilm from a target site of a human patient. A bacterial biofilm removal system is provided that includes an endoscope, an irrigation duct and an aspiration duct. The endoscope includes a working end. The irrigation duct includes an outlet. The aspiration duct includes an inlet. The endoscope working end, the irrigation duct outlet and the aspiration duct inlet are disposed proximate a target site that includes a layer of bacterial biofilm. The target site is imaged with the endoscope working end. The fluid is dispensed through the irrigation duct outlet toward the target site to mechanically remove at least a portion of the layer of bacterial biofilm. The removed bacterial biofilm and the dispensed fluid are collected with the aspiration duct inlet.

First claim

The invention claimed is:

1. A method of removing bacterial biofilm from a target site of a human patient, wherein the method comprises:
providing a handle comprising a support portion, a gripping portion that extends from the support portion, a first irrigation duct, a first aspiration duct and a first sheath interface and wherein the first sheath interface is at a distal end of the handle and includes a first irrigation duct outlet attached to the first irrigation duct and a first aspiration duct inlet attached to the first aspiration duct;
attaching an endoscope to the support portion, wherein the endoscope comprises a working end;
covering at least a portion of the endoscope working end with a removable endoscope sheath, wherein the removable endoscope sheath comprises a second irrigation duct, a second aspiration duct and a release member, wherein the second irrigation duct comprises an outlet, wherein the second aspiration duct comprises an inlet and, wherein the removable endoscope sheath comprises a second sheath interface and wherein the second sheath interface is at a proximal end of the removable endoscope sheath and comprises a second irrigation duct inlet attached to the second irrigation duct, a second aspiration duct outlet attached to the second aspiration duct and the release member;
engaging the endoscope with the release member to retain the removable endoscope sheath on the portion of the endoscope working end;
sealing the first irrigation duct outlet to the second irrigation duct inlet with the first sheath interface and the second sheath interface;
sealing the first aspiration duct inlet to the second aspiration duct outlet with the first sheath interface and the second sheath interface;
disposing the endoscope working end, the second irrigation duct outlet and the second aspiration duct inlet proximate a target site including a layer of bacterial biofilm;
imaging the target site with the endoscope working end;
dispensing fluid through the second irrigation duct outlet toward the target site to mechanically remove at least a portion of the layer of bacterial biofilm;
collecting the removed bacterial biofilm and the dispensed fluid with the second aspiration duct inlet;
deflecting the release member to disengage the release member from the endoscope; and
sliding the removable endoscope sheath off the portion of the endoscope working end.

2. The method of claim 1 , wherein the bacterial biofilm is characterized by an adhesion force and wherein the fluid is further adapted to chemically reduce the adhesion force.

3. The method of claim 1 , and further comprising applying a medicament to the target site through the second irrigation duct, wherein the medicament is adapted to inhibit re-growth of the bacterial biofilm.

4. The method of claim 1 , and further comprising delivering a medicament to the target site through the second irrigation duct, wherein the medicament is selected from the group consisting of a surfactant, a gel, an antimicrobial, a steroid, a growth hormone or combinations thereof.

5. The method of claim 1 , wherein the flow of fluid is directed through the second irrigation duct outlet at a flow rate of between about 2 ml/s and about 12 ml/s.

6. The method of claim 1 , wherein the second irrigation duct outlet and the second aspiration duct inlet are non-concurrently disposed proximate the target site.

7. The method of claim 1 , wherein the target site is within a sinus cavity.

8. The method of claim 1 , wherein the target site includes ciliated epithelium.

9. The method of claim 1 , wherein the method is performed in treating chronic rhinosinusitis.

10. The method of claim 1 , wherein the endoscope further comprises an insertion tube having a bendable distal portion and wherein the endoscope further comprises a control assembly for bending of the bendable distal portion to aim the endoscope working end in a desired direction.

11. The method of claim 10 , wherein the second irrigation duct outlet is secured relative to the bendable distal portion such that the second irrigation duct outlet can be aimed with bending of the insertion tube.

12. The method of claim 10 , wherein the second aspiration duct inlet is secured relative to the bendable distal portion such that the second aspiration duct inlet can be aimed with bending of the insertion tube.

13. A method of removing bacterial biofilm from a target site of a human patient, wherein the method comprises:
providing a handle comprising a support portion, a gripping portion that extends from the support portion, a first irrigation duct, a first aspiration duct and a first sheath interface and wherein the first sheath interface is at a distal end of the handle and comprises a first irrigation duct outlet attached to the first irrigation duct and a first aspiration duct inlet attached to the first aspiration duct;
attaching an endoscope to the support portion, wherein the endoscope comprises a working end;
extending at least a portion of the endoscope working end into a removable endoscope sheath, wherein the removable endoscope sheath comprises a second irrigation duct, a second aspiration duct and a release member formed therein, wherein the second irrigation duct comprises an outlet, wherein the second aspiration duct comprises an inlet and wherein the second sheath interface is at a proximal end of the removable endoscope sheath and comprises a second irrigation duct inlet attached to the second irrigation duct, a second aspiration duct outlet attached to the second aspiration duct and the release member;
engaging the endoscope with the release member on the removable endoscope sheath to retain the removable endoscope sheath on the portion of the endoscope working end;
sealing the first irrigation duct outlet to the second irrigation duct inlet with the first sheath interface and the second sheath interface;
sealing the first aspiration duct inlet and the second aspiration duct outlet with the first sheath interface and the second sheath interface;
disposing the endoscope working end, the second irrigation duct outlet and the second aspiration duct inlet proximate a target site including a layer of bacterial biofilm;
imaging the target site with the endoscope working end;
dispensing fluid through the second irrigation duct outlet toward the target site to mechanically remove at least a portion of the layer of bacterial biofilm;
collecting the removed bacterial biofilm and the dispensed fluid with the second aspiration duct inlet;
deflecting the release member to disengage the release member from the endoscope; and
sliding the removable endoscope sheath off the portion of the endoscope working end.

14. The method of claim 13 , wherein the bacterial biofilm is characterized by an adhesion force and wherein the fluid is further adapted to chemically reduce the adhesion force.

15. The method of claim 13 , and further comprising applying a medicament to the target site through the second irrigation duct, wherein the medicament is adapted to inhibit re-growth of the bacterial biofilm.

16. The method of claim 13 , and further comprising delivering a medicament to the target site through the second irrigation duct, wherein the medicament is selected from the group consisting of a surfactant, a gel, an antimicrobial, a steroid, a growth hormone or combinations thereof.

17. The method of claim 13 , wherein the second irrigation duct outlet and the second aspiration duct inlet are non-concurrently disposed proximate the target site.

18. The method of claim 13 ,

Assignees

• Slenker Dale E
• Lewis Cecil “Bo” O
• Norman Gerould W
• Prisco John R
• Medtronic Xomed Inc

Inventors

• Slenker Dale E
• Lewis Cecil “Bo” O
• Norman Gerould W
• Prisco John R

Classifications

• A61M1/774

  Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently · CPC title

• A61M3/0283

  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) · CPC title

• A61B1/00135

  Oversleeves mounted on the endoscope prior to insertion · CPC title

• A61B1/00091 Primary

  Nozzles · CPC title

• A61M1/0064

  Human Necessities · mapped topic