Intraoperative determination of nerve location

Abstract

The invention provides methods for intraoperatively determining the location of nerves by use of fluorescent dyes. The methods are particularly useful for locating the cavernous nerves innervating the penis.

Description

CROSS-REFERENCES TO RELATED APPLICATIONS [0001] This application claims priority from and the benefit of U.S. Provisional Application 60 / 713,643, filed Sep. 2, 2005, the contents of which are incorporated for all purposes.STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSORED RESEARCH AND DEVELOPMENT [0002] NOT APPLICABLE Reference to a “Sequence Listing,” a Table, or a Computer Program Listing Appendix Submitted on a Compact Disk [0003] NOT APPLICABLE BACKGROUND OF THE INVENTION [0004] A variety of medical techniques suitable for imaging biological tissues and organs are known. These include traditional x-rays, ultra-sound, magnetic resonance imaging, and computerized tomography. [0005] A variety of dyes useful for medical imaging have been described, including radio opaque dyes, fluorescent dyes, and colorimetric dyes (see e.g., U.S. Pat. Nos. 5,699,798; 5,279,298; 6,351,663). Imaging techniques and systems using fluorescent dyes have been described for the heart and ...

AI Technical Summary

Benefits of technology

[0011] The invention provides methods of determining the location of a nerve or portion of a nerve of interest in a subject during a surgical operation. The methods comprise, prior to the surgical operation, administering to an organ or area of the subject innervated by the nerve or portion of a nerve of interest a dye which fluoresces at an emission wavelength when the dye is contacted with an excitation wavelength, whereby the dye is taken up by or proceeds along the path of the nerve; exposing the nerve or portion of nerve during said operation to illumination comprising said excitation wavelength, thereby causing the fluorescent dye in or along the nerve or portion thereof to fluoresce; and detecting the fluorescence of the dye, thereby determining the location of said nerve or portion of nerve during said surgical operation. In some embodiments, the dye is injected into a cavernous body of the penis. In some embodiments, the injection into the cavernous body is into a crus of said cavernous body. In some embodiments, the dye is injected by epidural injection. In some embodiments, the nerve is transected during the surgical operation, creating two ends, and the detection of fluorescence of step is used to determine the location of the two ends. In some embodiments, the determination of the location of the two ends of the transected nerv

Problems solved by technology

Many continue to have intermittent problems with dribbling caused by coughing or exertion.

Damage to nerves which innervate both the prostate and the penis plays a significant part in these unwanted side effects.

Successful nerve sparing surgery, however, is often difficult to achieve because of the difficulty in distinguishing between the prostate tissue, in particular the cancerous prostate tissue, and the innervating nerve tissue.

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