Tissue cutting device

• US 20050222598A1
• Filed: 04/05/2004
• Published: 10/06/2005
• Est. Priority Date: 04/05/2004
• Status: Abandoned Application

• Current Assignee: Acueity Healthcare, Inc.
• Original Assignee: Manoa Medical, Inc.
• Inventors: Lee, Roberta, Ho, Huddee Jacob, Zuckswert, Samuel E.
• Application Number:
  US10/819,083
• Publication Number:
  US 20050222598A1
• Time in Patent Office: Days
• US Class Current: 606/171
• 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 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3201 Scissors for biopsy A61B10/02
• 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 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/32007 with suction or vacuum means
• CPC Class Codes: A61B 2017/320071 with articulating means for working tip

Abstract

Devices for efficient severing or cutting of a material or substance such as soft tissue suitable for use in open surgical and/or minimally invasive procedures are disclosed. A cutting assembly generally includes a first and second cutting blades each having an inner surface and at least one set of cutting teeth, the first inner surface being in contact with the second inner surface so that the sets of cutting teeth of the first and second cutting blades are aligned with and configured to cooperate with each other when at least one of the cutting blades moves, e.g., rotates and/or oscillates, relative to the other. A tissue cutting device generally includes a probe and the cutting assembly configured to be in a storage configuration or in a cutting configuration. The cutting assembly may provide a coagulation mechanism.

Claims

1. A tissue cutting device, comprising:

a probe defining a probe axis; and

a cutting assembly configured to be in one of a storage configuration and a cutting configuration including;

a first cutting blade having a first inner surface, a first cutting edge, and a first set of cutting teeth disposed along at least a portion of the first cutting edge; and

a second cutting blade having a second inner surface, a second cutting edge, and a second set of cutting teeth disposed along at least a portion of the second cutting edge, the cutting assembly being configured with the first inner surface being in contact with and in close apposition with the second inner surface so that the first set of cutting teeth is aligned with and configured to cooperate with the second set of cutting teeth when at least one of the first and second cutting blades moves relative to the other when the cutting assembly is in the cutting configuration.

2. The tissue cutting device of claim 1, further comprising a cutting apparatus coupled to the cutting assembly, the cutting apparatus being configured to at least one of rotate and oscillate at least one of the cutting blades relative to the other, the oscillation having a peak to peak distance of at least a distance between two adjacent cutting teeth on at least one of the first set of cutting teeth and the second set of cutting teeth.

3. The tissue cutting device of claim 2, wherein the cutting apparatus is configured to at least one of rotate and oscillate the first cutting blade and wherein the second cutting blade is stationary relative to the probe.

4. The tissue cutting device of claim 2, wherein the cutting apparatus is configured to at least one of rotate and oscillate the cutting blades relative to each other in opposing directions.

5. The tissue cutting device of claim 1, wherein at least one of the first cutting blade and the second cutting blade has more than one cutting edge and more than one set of cutting teeth.

6. The tissue cutting device of claim 1, wherein the cutting teeth of at least a portion of at least one of the sets of cutting teeth includes edge serrations.

7. The tissue cutting device of claim 1, wherein each of the cutting blades has at least one of high elasticity, shape memory property and superelastic property.

8. The tissue cutting device of claim 1, wherein at least one of the cutting blades is coupled to an energy source selected from radio frequency, laser and ultrasonic energy, heat, cold, and air or liquid pressure.

9. The tissue cutting device of claim 8, wherein at least one of the cutting blades is at least partially insulated.

10. The tissue cutting device of claim 1, wherein the first cutting blade provides a first blade aligner and the second cutting blade provides a second blade aligner configured to cooperate with the first blade aligner to align the first and second cutting blades relative to each other.

11. The tissue cutting device of claim 1, wherein the cutting assembly is configured to be in the storage configuration when retracted into the probe and is at least partially in the cutting configuration when extended from a distal end of the probe.

12. The tissue cutting device of claim 1, wherein the probe includes a cover slidable between a proximal and a distal position, wherein when the cover is in the distal position, the cover at least partially houses the cutting assembly in the storage configuration and when the cover is in the proximal position, the cutting assembly is at least partially in the cutting configuration.

13. The tissue cutting device of claim 1, wherein the cutting assembly generally extends along the probe axis.

14. The tissue cutting device of claim 1, wherein the first and second cutting blades are generally circle sectors in shape and at least one of the first and second cutting blades is configured to pivot relative to the other about a cutting assembly pivot.

15. The tissue cutting device of claim 1, wherein the first cutting blade forms an outer cylinder and the second cutting blade forms an inner cylinder abutting and nesting within the first cutting blade, wherein the cutting assembly defines a cutting direction generally in alignment with the probe axis.

16. The tissue cutting device of claim 1, wherein the cutting assembly is configured as at least part of a loop, the device further comprising:

a loop holder defining a loop holder axis generally orthogonal to the probe axis, the loop holder being configured to hold and to rotate the cutting assembly about the loop holder axis when the cutting assembly is in the cutting configuration so as to adjust a loop angle defined between the probe axis and the cutting assembly.

17. The tissue cutting device of claim 1, wherein the probe defines at least one opening along a length of the probe in a distal region thereof from which the cutting assembly extends from the storage configuration to the cutting configuration in a direction generally orthogonal to the probe axis.

18. The tissue cutting device of claim 1, comprising a plurality of the cutting assemblies each defining a cutting axis generally orthogonal to the probe axis, the device further comprising:

a loop cable coupled to the plurality of the cutting assemblies, the cutting assemblies being disposed circumferentially about the loop cable, the plurality of the cutting assemblies and the loop cable and the plurality of the cutting assemblies being configured to be rotatable about the probe axis.

19. The tissue cutting device of claim 1, wherein the cutting direction is generally one of orthogonal to the probe axis, parallel to the probe axis and rotational around the probe axis.

20. The tissue cutting device of claim 1, further comprising a tissue collector coupled to at least one of the cutting assembly and the probe.

21. The tissue cutting device of claim 1, further comprising a coagulator integrated with the cutting assembly.

22. The tissue cutting device of claim 21, wherein the coagulator is disposed on at least one of the first and second outer surfaces of the cutting blades.

23. The tissue cutting device of claim 21, wherein the coagulator is coupled to an energy source selected from a radio frequency energy, laser, cold, ultrasonic heating, and electrical resistive heating source.

24. The tissue cutting device of claim 21, wherein the coagulator is an inductive coil configured around at least a portion of at least one of the first and second cutting blades.

25. The tissue cutting device of claim 24, further comprising an energy source coupled to the coagulator and configured to deliver an electrical current through the inductive coil to cause at least part of the cutting assembly surrounded by the inductive coil to increase in temperature through inductive heating.

26. The tissue cutting device of claim 21, further comprising a temperature sensor incorporated into the cutting assembly to provide a feedback mechanism for controlling a temperature of at least one of the cutting blades and the coagulator.

27. The tissue cutting device of claim 1, wherein the probe and the cutting assembly are configured as a first unit attachable to a handle.

28. The tissue cutting device of claim 27, further comprising at least one additional attachable units each being selectively attachable to the handle.

29. A method for cutting tissue, comprising:

positioning a distal region of a probe of a tissue cutting device adjacent to a region of tissue to be severed, the probe defining a probe axis;

returning a cutting assembly from a storage configuration to a cutting configuration;

moving at least one of a first cutting blade and a second cutting blade of the cutting assembly relative to the other, the moving being at least one of rotating and oscillating, the first cutting blade having a first inner surface, a first cutting edge, and a first set of cutting teeth disposed along at least a portion of the first cutting edge, the second cutting blade having a second inner surface, a second cutting edge, and a second set of cutting teeth disposed along at least a portion of the second cutting edge, the first inner surface being in contact and in close apposition with the second inner surface so that the first set of cutting teeth is aligned with and configured to cooperate with the second set of cutting teeth when at least one of the first and second cutting blades moves relative to the other; and

one of advancing and retracting the tissue cutting device during the moving of the cutting blades such that the cutting assembly severs the tissue.

30. The method for cutting tissue of claim 29, wherein the first and second cutting blades have more than one cutting edge and more than one set of cutting teeth, wherein the advancing and retracting of the tissue cutting device severs the tissue.

31. The method for cutting tissue of claim 29, wherein the cutting teeth of at least a portion of at least one of the sets of cutting teeth includes edge serrations.

32. The method for cutting tissue of claim 29, wherein the moving is at least one of rotating and oscillating the first cutting blade, the second cutting blade being stationary relative to the probe, and the oscillating having a peak to peak distance of at least a distance between two adjacent cutting teeth on at least one of the first set of cutting teeth and the second set of cutting teeth.

33. The method for cutting tissue of claim 29, wherein the moving includes one of rotating and oscillating the cutting blades relative to each other in opposing directions.

34. The method for cutting tissue of claim 29, wherein at least one of the first cutting blade and the second cutting blade has more than one cutting edge and more than one set of cutting teeth.

35. The method for cutting tissue of claim 29, wherein each of the cutting blades has at least one of high elasticity, shape memory property and superelastic property.

36. The method for cutting tissue of claim 29, wherein at least one of the cutting blades is coupled to an energy source selected from radio frequency, laser and ultrasonic energy, heat, cold, and air or liquid pressure.

37. The method for cutting tissue of claim 36, wherein at least one of the cutting blades is at least partially insulated.

38. The method for cutting tissue of claim 29, wherein the returning of the cutting assembly to at least partially the cutting configuration from the storage configuration includes at least extending the cutting assembly from a distal region of the probe.

39. The method for cutting tissue of claim 29, wherein the returning of the cutting assembly to at least partially the cutting configuration from the storage configuration includes sliding a probe cover from a distal to a proximal position, wherein when the probe cover is in the distal position, the probe cover at least partially houses the cutting assembly in the storage configuration and when the probe cover is in the proximal position, the cutting assembly is at least partially in the cutting configuration.

40. The method for cutting tissue of claim 29, wherein the cutting assembly generally extends along the probe axis.

41. The method for cutting tissue of claim 29, wherein the first and second cutting blades are generally circle sectors in shape and at least one of the first and second cutting blades is configured to pivot relative to the other about a cutting assembly pivot.

42. The method for cutting tissue of claim 29, wherein the moving at least one of the cutting blades relative to the other causes a circular cut in the tissue created by the first cutting blade forming an outer cylinder and the second cutting blade forming an inner cylinder abutting and nesting within the first cutting blade and wherein the advancing defines a cutting direction generally in alignment with the probe axis.

43. The method for cutting tissue of claim 29, wherein the returning includes extending the cutting assembly out of at least one opening defined along a length of the probe in a distal region thereof from the storage configuration to the cutting configuration in a direction generally orthogonal to the probe axis.

44. The method for cutting tissue of claim 29, further comprising:

rotating a plurality of the cutting assemblies each defining a cutting axis generally orthogonal to the probe axis and coupled to each other circumferentially via a loop cable.

45. The method for cutting tissue of claim 29, further comprising:

rotating a loop holder to rotate the cutting assembly configured as at least part of a loop attached to the loop holder about a loop holder axis defined by the loop holder, the loop holder axis being generally orthogonal to the probe axis, the rotating adjusts a loop angle defined between the probe axis and the cutting assembly.

46. The method for cutting tissue of claim 29, further comprising collecting the cut tissue with a tissue collector coupled to at least one of cutting assembly and the probe.

47. The method for cutting tissue of claim 29, wherein the cutting direction is generally one of orthogonal to the probe axis, parallel to the probe axis, and rotational around the probe axis.

48. The method for cutting tissue of claim 29, further comprising applying an energy to a coagulator integrated with the cutting assembly.

49. The method for cutting tissue of claim 48, wherein the energy is selected from the group consisting of radio frequency energy, laser, cold, ultrasonic heating, and electrical resistive heating.

50. The method for cutting tissue of claim 48, wherein the coagulator is an inductive coil configured around at least a portion of at least one of the first and second cutting blades.

51. The method for cutting tissue of claim 50, wherein the applying the energy includes delivering an electrical current through the coagulator, the coagulator being an inductive coil, and the applying the energy causing at least part of the cutting assembly surrounded by the inductive coil to increase in temperature through inductive heating.

52. The method for cutting tissue of claim 48, further comprising:

sensing a temperature in the cutting assembly and controlling a temperature of at least one of the cutting blades and the coagulator.

53. The method for cutting tissue of claim 29, wherein the probe and the cutting assembly are configured as a unit attachable to a handle, further comprising;

selecting an attachable unit from a plurality of the attachable units, each of the plurality of attachable units being selectively attachable to the handle; and

attaching the selected attachable unit to the handle.