Medical device for removing an implanted object

• US 10,314,615 B2
• Filed: 02/12/2018
• Issued: 06/11/2019
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Original Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Inventors: Carver, Robert, Lee, Weston H., Kagarise, Brian E., Hoo, Bruce A., Gleason, Peter Wilbur, Halbert, Phillip Charles
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Morales, John Eric C
• Application Number:
  US15/894,602
• Publication Number:
  US 20180161055A1
• Time in Patent Office: 484 Days
• Field of Search: 606129, 606159, 606170
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3205 Excision instruments
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/50 Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body locating otherwise A61B5/06; locating by radiation A61B6/00; removing calculi A61B17/22; from the eyes A61F9/00709
• CPC Class Codes: A61B 2017/00986 Malecots, e.g. slotted tubes, of which the distal end is pulled to deflect side struts
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0573 chacterised by means penetrating the heart tissue, e.g. helix needle or hook
• CPC Class Codes: A61N 2001/0578 having means for removal or extraction

Abstract

Methods and devices for separating an implanted object, such as a pacemaker lead, from tissue surrounding such object in a patient'"'"'s vasculature system. Specifically, the surgical device includes a handle, an elongate sheath and a circular cutting blade that extends from the distal end of the sheath upon actuating the handle. The circular cutting blade is configured to engage the tissue surrounding an implanted lead and cut such tissue in a coring fashion as the surgical device translates along the length of the lead, thereby allowing the lead, as well as any tissue remaining attached to the lead, to enter the device'"'"'s elongate shaft. The surgical device has a barrel cam cylinder in the handle assembly that imparts rotation of the blade and a separate cam mechanism in the tip of outer sheath assembly that imparts and controls the extension and retraction of the blade. The barrel cam cylinder and cam mechanism cooperate to cause the blade to rotate in a first direction and extend from and retract in the outer sheath due to a first actuation of the handle and to rotate in a second direction and extend and retract in the outer sheath due to a second actuation of the handle.

Claims

1. A device for removing an implanted object from a body vessel, the device comprising:

an outer sheath assembly comprising a proximal end, a distal end, and a pin;

an inner sheath disposed within the outer sheath assembly, the inner sheath being rotatable relative to the outer sheath assembly, and the inner sheath comprising a proximal end and a distal end;

a tip coupled to the distal end of the inner sheath and being rotatable with the inner sheath relative to the outer sheath assembly, the tip comprising;

a cutting surface opposite the inner sheath;

a cam slot receiving and cooperating with the pin, the cam slot and the pin cooperating to cause the tip to move longitudinally relative to the outer sheath assembly as the tip rotates relative to the outer sheath assembly;

a trigger comprising a trigger pin; and

a barrel cam cylinder coupled to the inner sheath, the barrel cam cylinder comprising a barrel cam cylinder slot receiving and cooperating with the trigger pin;

wherein upon the trigger and the trigger pin moving proximally, the trigger pin and the barrel cam cylinder slot cooperate to cause the barrel cam cylinder and the inner sheath to rotate in both a clockwise direction and a counter clockwise direction, thereby causing the tip to rotate in both the clockwise direction and the counter clockwise direction relative to the outer sheath assembly while the tip moves longitudinally relative to the outer sheath assembly.

2. The device of claim 1, further comprising a handle assembly, the handle assembly comprising the trigger and coupling to the outer sheath assembly.

3. The device of claim 2, further comprising an outer key comprising a lumen and an inner key received in the lumen, wherein the inner key is coupled to the barrel cam cylinder.

4. The device of claim 3, wherein the inner key is rotatable within the lumen of the outer key.

5. The device of claim 3, wherein the inner key is longitudinally movable relative to the outer key.

6. The device of claim 3, wherein the lumen of the outer key comprises a proximal end and a distal end, and wherein the lumen has a larger diameter at the proximal end of the lumen relative to the distal end of the lumen.

7. The device of claim 6, wherein the lumen of the outer key comprises an abutment between the proximal end of the lumen and the distal end of the lumen.

8. The device of claim 2, wherein the handle assembly further comprises a spring coupled to the trigger.

9. The device of claim 8, wherein the spring is a constant force spring.

10. The device of claim 1, wherein the tip extends from and retracts into the outer sheath assembly while the barrel cam cylinder rotates in the first direction.

11. The device of claim 10, wherein the tip extends from and retracts into the outer sheath assembly while the barrel cam cylinder rotates in the second direction.

12. The device of claim 1, wherein the tip extends from and retracts into the outer sheath assembly while the barrel cam cylinder rotates in the second direction.

13. The device of claim 1, wherein the trigger pin is normally disposed in a home position in the barrel cam cylinder slot, and the trigger pin traverses the barrel cam cylinder slot and returns to the home position upon actuation of the trigger.

14. The device of claim 1, wherein the trigger pin is normally disposed in a home position in the barrel cam cylinder slot, wherein upon the trigger and the trigger pin moving proximally, the trigger pin moves from the home position to an intermediate position in the barrel cam cylinder slot to cause the barrel cam cylinder and the inner sheath to rotate in both the clockwise direction and the counter clockwise direction, thereby causing the tip to rotate in both the clockwise direction and the counter clockwise direction relative to the outer sheath assembly while the tip moves longitudinally relative to the outer sheath assembly, and wherein upon the trigger and the trigger pin moving distally, the trigger pin moves from the intermediate position to the home position.

15. The device of claim 14, wherein the trigger pin traverses a first portion of the barrel cam cylinder slot when moving from the home position to the intermediate position, and the trigger pin traverses a second portion of the barrel cam cylinder slot when moving from the intermediate position to the home position.