Lithotripsy Probes and Methods for Performing Lithotripsy

Abstract

Various medical devices are described herein. More particularly, various probes used for performing lithotripsy and methods of performing lithotripsy are described. In an example, a probe comprises an elongate member comprising a proximal end, a distal end, a proximal portion, an intermediate portion, and a distal portion. The proximal portion has an outer diameter that is greater than the outer diameter of the distal portion.

1 . A method of performing lithotripsy on a stone disposed in a bodily passage, the method comprising the steps of:
 inserting a sheath having a first proximal end and a first distal end into said bodily passage such that the first distal end is disposed in said bodily passage, the sheath defining a first lumen extending between an opening at the first proximal end and an opening at the first distal end and having a first inner diameter and first lumen length;   inserting a scope having a second proximal end and a second distal end through the first lumen such that the second distal end is disposed distal to the first distal end of the sheath, the scope defining a second lumen extending between an opening at the second proximal end and an opening at the second distal end and having a second inner diameter and second lumen length;   inserting a lithotripter comprising a firing handle and a probe having a third proximal end and a third distal end through the second lumen such that the third distal end is disposed distal to the second distal end of the scope, the probe comprising:
 an elongate member comprising a fourth proximal end, a fourth distal end, a proximal portion, an intermediate portion, and a distal portion, the proximal portion having a first length and a first outer diameter, the intermediate portion having a second length and a second outer diameter, the distal portion having a third length and a third outer diameter, the intermediate portion disposed between the proximal portion and the distal portion, the first outer diameter being greater than the third outer diameter, the second outer diameter tapering from the first outer diameter to the third outer diameter, and the third length of the distal portion being greater than the second lumen length of the scope; and 
 a fitting disposed on the fourth proximal end of the elongate member and adapted to attach the probe to the lithotripter, the fitting having a fifth proximal end and a fifth distal end; 
   navigating the third distal end of the probe towards said stone;   contacting the third distal end of the probe with said stone; and   activating the firing handle of the lithotripter to fragment said stone.   
     
     
         2 . The method of  claim 1 , further comprising the steps of:
 removing the probe from the second lumen of the scope;   removing the scope from the first lumen of the sheath;   inserting a medical device having a sixth proximal end and a sixth distal end through the first lumen of the sheath such that the sixth distal end of the medical device is disposed distal to the first distal end of the sheath;   activating the medical device to remove the fragmented stone; and   removing the medical device from the first lumen of the sheath.   
     
     
         3 . The method of  claim 1 , wherein the probe further comprises:
 an elongate tubular member disposed over a portion of the first length of the proximal portion, the elongate tubular member comprising a sixth proximal end disposed adjacent to the fifth distal end of the fitting and a sixth distal end disposed proximal to the intermediate portion; and   a handle disposed over the intermediate portion of the elongate member, the handle comprising a seventh proximal end and a seventh distal end, the seventh proximal end attached to the sixth distal end of the elongate tubular member.   
     
     
         4 . A method of performing lithotripsy on a stone disposed in a bodily passage, the method comprising:
 inserting a device having a first proximal end and a first distal end into said bodily passage such that the first distal end is disposed in said bodily passage, the device defining a first lumen;   inserting a lithotripter comprising a probe having a second proximal end and a second distal end through the first lumen such that the second distal end is disposed distal to the first distal end of the device, the probe comprising:
 an elongate member comprising a third proximal end, a third distal end, a proximal portion, an intermediate portion, and a distal portion, the proximal portion having a first outer diameter, the intermediate portion having a second outer diameter, the distal portion having a third outer diameter, the intermediate portion disposed between the proximal portion and the distal portion, the first outer diameter being greater than the third outer diameter, the second outer diameter tapering from the first outer diameter to the third outer diameter; 
   navigating the second distal end towards said stone;   contacting the second distal end with said stone; and   activating the lithotripter to fragment said stone.   
     
     
         5 . The method of  claim 4 , wherein the device comprises a sheath. 
     
     
         6 . The method of  claim 5 , wherein the sheath has a length; and
 wherein the distal portion has a length that is greater than then length of the sheath.   
     
     
         7 . The method of  claim 6 , further comprising inserting a scope having a fourth proximal end and a fourth distal end through the first lumen such that the fourth distal end is disposed distal to the first distal end of the sheath, the scope defining a second lumen; and
 wherein inserting a lithotripter comprising a probe having a second proximal end and a second distal end through the first lumen such that the second distal end is disposed distal to the first distal end of the device comprises inserting a lithotripter comprising a probe having a second proximal end and a second distal end through the second lumen such that the second distal end is disposed distal to the fourth distal end of the scope.   
     
     
         8 . The method of  claim 7 , further comprising the steps of:
 removing the probe from the second lumen of the scope;   removing the scope from the first lumen of the sheath;   inserting a medical device having a fifth proximal end and a fifth distal end through the first lumen of the sheath such that the fifth distal end of the medical device is disposed distal to the first distal end of the sheath;   activating the medical device to remove fragmented stone from said bodily passage; and   removing the medical device from the first lumen of the sheath.   
     
     
         9 . The method of  claim 7 , wherein the scope has a length that is greater than the length of the sheath. 
     
     
         10 . The method of  claim 4 , wherein the device comprises a scope. 
     
     
         11 . The method of  claim 10 , further comprising the steps of:
 removing the probe from the first lumen of the scope;   inserting a medical device having a fourth proximal end and a fourth distal end through the first lumen of the scope such that the fourth distal end of the medical device is disposed distal to the first distal end of the scope;   activating the medical device to remove fragmented stone from said bodily passage; and   removing the medical device from the first lumen of the scope.   
     
     
         12 . The method of  claim 10 , wherein the first lumen of the scope has a length; and
 wherein the distal portion has a length that is greater than the length of the first lumen of the scope.   
     
     
         13 . The method of  claim 4 , wherein the probe further comprises:
 a fitting disposed on the third proximal end of the elongate member, the fitting having a fourth proximal end and a fourth distal end;   an elongate tubular member disposed over a portion of the proximal portion, the elongate tubular member comprising a fifth proximal end and a fifth distal end, the fifth proximal end disposed adjacent to the fourth distal end of the fitting; and   a handle disposed on the elongate member, the handle comprising a sixth proximal end attached to the fifth distal end of the elongate tubular member.   
     
     
         14 . The method of  claim 13 , wherein the fifth distal end of the elongate tubular member is disposed proximal to the intermediate portion. 
     
     
         15 . The method of  claim 13 , wherein the handle is moveable between a first configuration and a second configuration, in the first configuration the elongate tubular member and the handle are slidably disposed on the elongate member, in the second configuration the elongate tubular member and the handle are releasably attached to the elongate member. 
     
     
         16 . The method of  claim 15 , wherein the handle is disposed over the intermediate portion of the elongate member when the handle is in the second configuration. 
     
     
         17 . The method of  claim 13 , wherein the entire elongate tubular member is disposed between the fourth distal end of the fitting and the second distal end of the elongate member. 
     
     
         18 . The method of  claim 4 , wherein said bodily passage is a salivary duct. 
     
     
         19 . The method of  claim 4 , wherein said bodily passage is a portion of a urinary tract. 
     
     
         20 . A method of performing lithotripsy on a stone disposed in a bodily passage, the method comprising:
 inserting a sheath having a first proximal end and a first distal end into said bodily passage such that the first distal end is disposed in said bodily passage, the sheath having a length and defining a first lumen;   inserting a scope having a second proximal end and a second distal end through the first lumen of the sheath such that the second distal end is disposed distal to the first distal end of the sheath, the scope defining a second lumen having a second lumen length;   inserting a lithotripter comprising a probe having a third proximal end and a third distal end through the second lumen such that the third distal end is disposed distal to the second distal end of the scope, the probe comprising:
 an elongate member comprising a fourth proximal end, a fourth distal end, a proximal portion, an intermediate portion, and a distal portion, the proximal portion having a first outer diameter, the intermediate portion having a second outer diameter, the distal portion having a third outer diameter and a distal portion length, the intermediate portion disposed between the proximal portion and the distal portion, the first outer diameter being greater than the third outer diameter, the second outer diameter tapering from the first outer diameter to the third outer diameter, the distal portion length being greater than the length of the sheath, the distal portion length being greater than the second lumen length of the scope; 
 a fitting disposed on the fourth proximal end of the elongate member, the fitting having a fifth proximal end and a fifth distal end; 
 an elongate tubular member disposed over a portion of the proximal portion, the elongate tubular member comprising a sixth proximal end and a sixth distal end, the sixth proximal end disposed adjacent to the fifth distal end of the fitting; and 
 a handle disposed on the elongate member, the handle comprising a seventh proximal end attached to the sixth distal end of the elongate tubular member; 
   navigating the third distal end of the probe towards said stone;   contacting the third distal end of the probe with said stone; and   activating the lithotripter to fragment said stone.