Automated image-guided tissue resection and treatment

Abstract

A system to treat a patient comprises a user interface that allows a physician to view an image of tissue to be treated in order to develop a treatment plan to resect tissue with a predefined removal profile. The image may comprise a plurality of images, and the planned treatment is shown on the images. The treatment probe may comprise an anchor, and the image shown on the screen may have a reference image marker shown on the screen corresponding to the anchor. The planned tissue removal profile can be displayed and scaled to the image of the target tissue of an organ such as the prostate, and the physician can adjust the treatment profile based on the scaled images to provide a treatment profile in three dimensions. The images shown on the display may comprise segmented images of the patient with treatment plan overlaid on the images.

1 .- 18 . (canceled) 
     
     
         19 . A medical method, comprising:
 providing a water jet system, wherein the water jet system comprises a water jet fluid flush tube and an aspiration tube;   endoscopically inserting the water jet system into a patient;   utilizing a visualization element separate from the water jet system to visualize a treatment performed by the water jet system;   applying fluid from the water jet flush tube to create a cutting jet area to break apart tissue;   robotically controlling cutting motion by the water jet fluid flush tube to break apart the tissue;   controlling, based on feedback, a flow rate of the fluid from the water jet flush tube to control the cutting jet area to treat the tissue to be broken apart and spare injury to surrounding tissue; and   using the aspiration tube to remove the broken apart tissue via aspiration.   
     
     
         20 . The medical method of  claim 19 , further comprising attaching the water jet system to an arm. 
     
     
         21 . The medical method of  claim 20 , wherein the arm is a robotic arm, and wherein the robotic arm is coupled to the water jet system via an instrument driver. 
     
     
         22 . The medical method of  claim 19 , wherein the fluid comprises a saline solution. 
     
     
         23 . The medical method of  claim 19 , wherein the water jet system comprises a central processing unit for controlling the aspiration tube. 
     
     
         24 . The medical method of  claim 19 , wherein the applying fluid includes modulating a flow of the fluid. 
     
     
         25 . The medical method of  claim 19 , wherein a portion of the water jet fluid flush tube and a portion of the aspiration tube are co-axially disposed relative to one another. 
     
     
         26 . The medical method of  claim 19 , wherein the cutting motion includes a predefined shape. 
     
     
         27 . The medical method of  claim 19 , wherein the visualization element includes an ultrasound element. 
     
     
         28 . The medical method of  claim 19 , wherein the cutting jet area is controlled based at least in part on a pressure sensor. 
     
     
         29 . The medical method of  claim 19 , wherein the feedback includes a feedback loop based on the pressure of the fluid from the water jet flush tube. 
     
     
         30 . The medical method of  claim 19 , wherein the feedback includes a feedback loop based at least in part on the flow rate of the fluid from the water jet flush tube. 
     
     
         31 . The medical method of  claim 19 , wherein the feedback includes a feedback loop based at least in part on a measured pressure of the fluid from the water jet flush tube. 
     
     
         32 . The medical method of  claim 19 , wherein the feedback includes a feedback loop based on a measured flow rate of the fluid from the water jet flush tube. 
     
     
         33 . A medical method, comprising:
 providing a water jet system, wherein the water jet system comprises a water jet fluid flush tube and an aspiration tube;   endoscopically inserting the water jet system into a patient;   utilizing a visualization element separate from the water jet system to visualize a treatment performed by the water jet system;   applying fluid from the water jet flush tube to create a cutting jet area to break apart a target tissue;   robotically controlling cutting motion by the water jet fluid flush tube to break apart the target tissue;   controlling, based on feedback, a flow rate of the fluid from the water jet flush tube to resect the target tissue and spare injury to surrounding tissue, the controlling including monitoring a characteristic of the fluid from the water jet flush tube and changing the flow rate to control the cutting jet area; and   using the aspiration tube to remove the broken apart tissue via aspiration.   
     
     
         34 . The method of  claim 33 , wherein the changing includes changing the flow rate to maintain the pressure of the fluid from the water jet flush tube above a critical pressure of the target tissue at which the target tissue resects and below a critical pressure of the surrounding tissue at which the surrounding tissue resects to resect the target tissue and not the surrounding tissue. 
     
     
         35 . The method of  claim 33 , wherein the changing includes changing the flow rate such that the pressure of the fluid is sufficiently high to resect the target tissue and sufficiently low so as not to substantially resect the surrounding tissue. 
     
     
         36 . The method of  claim 33 , wherein the characteristic is an effect of the fluid on the target tissue and the monitoring includes visualizing the effect of the fluid on the target tissue using the visualization element. 
     
     
         37 . The method of  claim 33 , wherein the cutting jet area is controlled based at least in part on a pressure sensor. 
     
     
         38 . The method of  claim 33 , wherein the flow rate of the fluid is controlled by controllably driving a pump to deliver fluid through the water jet fluid flush tube.