Method and apparatus for surgical dissection

• US 20040049251A1
• Filed: 07/14/2003
• Published: 03/11/2004
• Est. Priority Date: 07/14/2002
• Status: Active Grant

• Current Assignee: InMode Ltd.
• Original Assignee: Edward W. Knowlton
• Inventors: Knowlton, Edward W.
• Granted Patent: US 7,442,192 B2
• Time in Patent Office: Days
• US Class Current: 607/101
• CPC Class Codes: A61B 17/32093 for skin incisions

Abstract

An apparatus for dissecting tissue in a substantially uniform plane of dissection includes a housing configured to be advanced under a tissue layer, and control one of a depth of dissection or tissue flap thickness. The housing thermally shields at least a portion of the tissue flap. A roller is coupled to the housing. The roller is configured to smoothly advance housing over tissue. An energy delivery device is coupled to housing. The energy delivery device is configured to be coupled to an energy source. The energy delivery device has a geometry that substantially defines a plane of dissection.

Claims

1. An apparatus for dissecting tissue in a substantially uniform plane of dissection, the apparatus comprising:

a housing configured to be advanced under a tissue layer and control one of a depth of dissection or tissue flap thickness;

housing being configured to thermally shield at least a portion of the tissue flap;

a roller coupled to housing, the roller configured to smoothly advance housing over tissue; and

an energy delivery device coupled to housing, the energy delivery device configured to be coupled to an energy source, the energy delivery device having a geometry substantially defining a plane of dissection.

2. An electro-surgical apparatus, comprising:

an electrode with a cutting edge; and

a housing coupled to the electrode and including a top with a top proximal section and a bottom with a bottom proximal section, the top proximal section having a geometry that facilitates creation of a skin flap with a substantially uniform thickness that includes a skin layer and an adjacent layer of subcutaneous tissue, the bottom proximal section having a geometry that preserves a plane of tissue that is positioned adjacent to the adjacent layer of subcutaneous tissue.

3. The apparatus of claim 2, wherein the housing includes a gap between the top proximal section and the bottom proximal section.

4. The apparatus of claim 2, wherein the housing includes a chamber that facilitates creation of the skin flap.

5. The apparatus of claim 2, wherein the bottom proximal section has a most proximal point at “

A”

, and the top proximal section has a most proximal point at “

B”

, wherein A is more proximal than B.

6. The apparatus of claim 5, wherein the bottom proximal section is defined by point A and a more distal point “

C”

.

7. The system of claim 6, wherein the electrode extends from Point A to point B.

8. The system of claim 7, wherein the electrode forms the hypoteneus of a triangle defined by points A, B, and a point “

D”

which is positioned at a more proximal position than point B.

9. The system of claim 8, wherein the bottom proximal section forms a hypotenuse of a triangle defined by points A, C and a point “

E”

, wherein E is more proximal than point C.

10. The system of claim 9, wherein the distance between points D and A is 1 mm to 2.5 cm.

11. The system of claim 9, wherein the distance between points D and B is 0 mm to 1.5 cm.

12. The system of claim 9, wherein the distance between points A and E is 0 mm to 1.5 cm.

13. The system of claim 9, wherein the distance between points E and C is 0 mm to 1.5 cm.

14. The apparatus of claim 2, further comprising:

an insulator coupled to at least a portion of the electrode.

15. A dissection apparatus, comprising:

an energy delivery device with an energy delivery surface; and

a housing coupled to the energy delivery device, the housing including a guide configured to permit the energy delivery surface provide a surgical plane of dissection to free a skin section and an underlying thickness of subcutaneous tissue while preserving an adjacent plane of tissue.

16. The apparatus of claim 15, wherein the energy delivery device is an electromagnetic energy delivery device.

17. The apparatus of claim 15, wherein the energy delivery device is an RF electrode.

18. The apparatus of claim 17, wherein the energy delivery surface is a cutting surface.

19. A tissue dissection apparatus, comprising:

an electrosurgical energy delivery device with an electrosurgical cutting edge; and

a housing coupled to the energy delivery device, the housing including a guard that guides and facilitates a dissection to create a surgical plane of dissection to free a skin section and an underlying thickness of subcutaneous tissue while preserving an adjacent plane of tissue.

20. A method of creating a tissue effect, comprising:

providing an electro-surgical device that includes an energy delivery device with an energy delivery surface, a housing coupled to the electrode with a guide that provides for cutting a skin layer and an underlying thickness of subcutaneous tissue while preserving an adjacent plane of tissue;

positioning the energy delivery surface at the skin surface;

delivering sufficient energy from the energy delivery device to cut the skin surface and the underlying thickness of subcutaneous tissue at a selected depth while preserving the adjacent plane of tissue.

21. The method of claim 20, wherein the selected depth is no more than 2 inches.

22. The method of claim 20, wherein the selected depth is no more than 1 inch.

23. The method of claim 20, wherein the selected depth is no more than 0.75 inch.

24. The method of claim 20, wherein the selected depth is no more than 0.50 inch.

25. The method of claim 20, wherein the selected depth is no more than 0.25 inch.

26. A method of creating a tissue effect, comprising:

providing an electro-surgical device that includes an electrode with a cutting edge, a housing coupled to the electrode with a guide that provides for cutting a skin layer and an underlying thickness of subcutaneous tissue while preserving an adjacent plane of tissue;

positioning the cutting edge at the skin surface;

cutting a skin surface and a layer of an adjacent underlying tissue; and

creating a tissue effect.

27. The method of claim 26, wherein the tissue effect is formation of a plane of an electrosurgical flap dissection that provides a uniform flap thickness that includes the layer of the adjacent underlying tissue.

28. The method of claim 26, wherein the tissue effect is formation of a plane of electrosurgical flap dissection that provides a variable flap thickness.

29. The method of claim 26, wherein the tissue effect is a reduced surface area in the plane of dissection due to flap uniformity.

30. The method of claim 26, wherein the tissue effect is uniform plane of wound healing with a reduction on volumetric scarring within the plane of dissection.

31. The method of claim 26, wherein the tissue effect is thermal tightening of the dissected skin flap.

32. The method of claim 26, wherein the tissue effect is a thermal molecular collagen contraction within the plane of dissection.

33. The method of claim 26, wherein the tissue effect is a wound healing contraction within the plane of dissection.

34. The method of claim 26, wherein the tissue effect is a reduction in iatrogenic surface contour irregularities of the flap surface.

35. The method of claim 26, wherein the tissue effect is a uniform release of subjacent soft tissue structures.