Devices and methods for tissue access
First Claim
1. A method to achieve access to target tissue in a patient, with minimal tissue damage, the method comprising:
- advancing a cannulated access device into tissue at a first location;
inserting a portion of a cannulated instrument through the access device, where on exiting from the cannulated access device the portion of the cannulated instrument assumes a curved shape;
advancing the cannulated instrument until the curved portion of the cannulated instrument is immediately adjacent to the target anatomy;
inserting a sharp, substantially straight, flexible element through the curved portion of the cannulated instrument, where the flexible element substantially straightens upon exiting the from the curved portion of the cannulated instrument; and
advancing the flexible element, away from the target anatomy until a distal tip of the flexible element exits the patient at a second location.
1 Assignment
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Accused Products
Abstract
Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.
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Citations
30 Claims
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1. A method to achieve access to target tissue in a patient, with minimal tissue damage, the method comprising:
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advancing a cannulated access device into tissue at a first location;
inserting a portion of a cannulated instrument through the access device, where on exiting from the cannulated access device the portion of the cannulated instrument assumes a curved shape;
advancing the cannulated instrument until the curved portion of the cannulated instrument is immediately adjacent to the target anatomy;
inserting a sharp, substantially straight, flexible element through the curved portion of the cannulated instrument, where the flexible element substantially straightens upon exiting the from the curved portion of the cannulated instrument; and
advancing the flexible element, away from the target anatomy until a distal tip of the flexible element exits the patient at a second location. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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26. A method to achieve access to target tissue in a patient, with minimal tissue damage, the method comprising:
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inserting a cannulated instrument into the patient in a first direction, where a distal portion of the cannulated instrument is made to assume a curved shape in the patient to advance in a second direction;
advancing the curved distal portion of the cannulated instrument immediately adjacent to the target anatomy;
inserting a sharp, substantially straight, flexible element through the cannulated instrument, where the flexible element substantially straightens upon exiting from the curved portion of the cannulated instrument; and
advancing the flexible element away from the target anatomy until a distal tip of the flexible element exits the body. - View Dependent Claims (27)
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28. A method to access target tissue anatomy in a patient, with minimal tissue damage, the method comprising:
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advancing a cannulated access device into tissue at a first location towards the targeted anatomy;
inserting a distal portion of an instrument through the cannulated access device, where on exiting the cannulated access device the distal portion assumes a curved shape;
advancing the distal portion of the instrument until immediately adjacent to the target anatomy;
substantially straightening the distal portion of the instrument;
advancing the substantially straightened distal portion of the instrument away from the target anatomy and out of the tissue until a distal tip of the instrument exits the body. - View Dependent Claims (29)
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30. A method to achieve access to the epidural space of a patient whose spine contains tissue which impinges on a neural or neural vascular tissue, the method comprising:
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advancing a cannulated access device having a sharp distal end to the epidural space;
inserting a cannulated instrument with a substantially blunt distal end through the cannulated access device, advancing the distal end of the cannulated instrument out of the distal end of the cannulated access device and through a neural foramen and anterior to a facet joint;
inserting a element having a sharp distal end through the cannulated instrument; and
advancing the element out of the distal end of the cannulated instrument and away from the neural foramen until a distal tip of the flexible element exits the patient.
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Specification