Disclosed are methods to induce dislodgement of target prostatic cells from the prostate organ, collecting said cells, and subsequently examining the cell population. Such methods comprise the administration of an agent that facilitates the dislodgement of the target cells from within the prostate, which then migrate into the urethra. Exemplary agents include 5 alpha-reductase inhibitors. The cells induced to pass into the urethra are then collected non-invasively, such as through urine or semen samples. Such collection is further strategically calculated relative the administration of the agent so as to maximize the sample collection of the target cells of interest. The exfoliated prostatic epithelial cells are subsequently utilized for purposes such as detecting prostate cancer, predicting/measuring prostate tumor susceptibility to drug regimes, active surveillance of patients whose prostate biopsy results are negative, but continue to exhibit symptoms consistent with prostate cancer, and identifying false positive results associated with biomarker assays.

An improved optical fiber comprising a waveguide with an input for coupling focused laser energy into the waveguide and communicating electromagnetic radiation in a propagation direction to an internally reflective tip of the waveguide, a tissue contacting surface wherein the light path from the reflecting surface to the transmitting surface in substantially homogenous in refractive index and cooled by fluid flow. In minimizing the variations in refractive index within the lateral light path, while providing active cooling directly below the tissue contact surface, the invention prevents internal reflections and beam distortion and greatly improves the efficiency and durability of the laterally directing probe. Free rotation of the tissue contact surface, about the lateral tip, may be provided and tissue vaporization efficiency may be improved by providing a morcellating tool on the tissue contact surface.

The present disclosure relates to a tool manipulator, comprising a base, mountable on an operation table. A caliper is supported by the base and a tool holder is mounted on the caliper. An actuator positionable below a patient supporting surface of the operation table receives positioning commands for moving a tool in at least three degrees of freedom. The tool manipulator can be made part of a system for positioning a needle for diagnosis or treatment of the prostate of a patient. The system also comprises a power source connected to the actuator and a controller controlling the provision of the positioning commands to the actuator.

A surgical treatment apparatus comprises a waterjet configured to fragment tissue and provide intact cells such as stem cells with the fragmented tissue. The intact cells can be used in one or more of many ways such as for genetic or other testing, and the intact cells can be identified as stem cells. In many embodiments, the intact cells comprise stem cells. In many embodiments, a waterjet is configured to fragment tissue. The fragmented tissue can be collected with a filter having pores sized smaller than the tissue fragments. In many embodiments cavitation with a waterjet is used to fragment the tissue comprising the intact stem cells. The waterjet may comprise a waterjet immersed in a liquid comprising water so as to form a plurality of shedding pulses. The plurality of shedding pulses can be generated with a frequency sufficient to fragment the tissue. The shedding pulses can generate cavitations that fragment the tissue.

Devices, systems and methods for compressing, cutting, incising, reconfiguring, remodeling, attaching, repositioning, supporting, dislocating or altering the composition of tissues or anatomical structures to alter their positional or force relationship to other tissues or anatomical structures. In some applications, the invention may be used to used to improve patency or fluid flow through a body lumen or cavity (e.g., to limit constriction of the urethra by an enlarged prostate gland).

A system and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device and a plurality of anchor assemblies. The delivery system is configured to deliver a first anchor using loaded energy and reload the energy required to deliver an addition anchor.

A transurethral system for delivering and depositing fiducial markers usable to delineate the prostate during radiation therapy.

A robot-assisted approach for transrectal ultrasound (TRUS) guided prostate biopsy includes a hands-free probe manipulator that moves the probe with the same 4 degrees-of-freedom (DoF) that are used manually. Transrectal prostate biopsy is taken one step further, with an actuated TRUS manipulation arm. The robot of the present invention enables the performance of hands-free, skill-independent prostate biopsy. Methods to minimize the deformation of the prostate caused by the probe at 3D imaging and needle targeting are included to reduce biopsy targeting errors. The present invention also includes a prostate coordinate system (PCS). The PCS helps defining a systematic biopsy plan without the need for prostate segmentation. A novel method to define an SB plan is included for 3D imaging, biopsy planning, robot control, and navigation.

A method and device for facilitating the anastomotic healing of a patient after a radical prostatectomy surgical procedure, without a urethral catheter, comprising the steps of performing a radical prostatectomy, fixedly positioning a splinting element between the urethra and the bladder, across the urethral opening, placing the splinting element during the performing of the radical prostatectomy and prior to surgical closure. The fixed positioning is effected from a position within the bladder with anchoring the splinting element in position relative to the interior of the bladder, setting a separate urine drainage tube, and removing the splinting element, after anastomotic healing, with a retrieval element on the splinting element or with dissolving of the splinting element.

A method of performing a transperineal biopsy procedure including the steps of: inserting an access needle into one of a plurality of needle receiving ports of a displacement member of a transperineal biopsy guide that is secured to the transrectal ultrasound probe; securing the access needle to the displacement member such that a position of the access needle relative to the displacement member is maintained; imaging the prostate of the patient with the transrectal ultrasound probe; inserting the access needle into the perineal access site of the patient; and inserting the biopsy needle through the access needle and into the prostate of the patient.