TISSUE EXCISION DEVICES AND METHODS

• US 20080221383A1
• Filed: 02/12/2008
• Published: 09/11/2008
• Est. Priority Date: 02/12/2007
• Status: Abandoned Application

• Current Assignee: Vertos Medical, Inc.
• Original Assignee: Vertos Medical, Inc.
• Inventors: Sand, Paul M., Way, Bryce, Cantu, Alberto, Tran, Minh, Mertens, Herbert H., Schomer, Donald F.
• Application Number:
  US12/029,816
• Publication Number:
  US 20080221383A1
• Time in Patent Office: Days
• US Class Current: 600/3
• CPC Class Codes: A61B 10/0275 with sample notch, e.g. on the side of inner stylet
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/295 combined with cutting implements
• 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 17/3421 Cannulas
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/2845 with a spring pushing the handle back
• CPC Class Codes: A61B 2017/2912 transmission of forces to actuating rod or piston
• CPC Class Codes: A61B 2017/292 connection of actuating rod to handle, e.g. ball end in recess
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means

Abstract

A tissue excision device comprises a handle. In addition, the tissue excision device comprises an elongate tissue capture member extending from the handle. The tissue capture member has a longitudinal axis and comprises a free end distal the handle. Further, the free end of the tissue capture member includes a tip, a tissue capture recess, and at least one slot extending through the free end in the tissue capture recess. Still further, the tissue excision device comprises an elongate tubular cutting member coupled to the handle. The cutting member slidingly and coaxially receives the tissue capture member. In addition, the cutting member has a free end distal the handle that includes a cutting.

Claims

1. A tissue excision device comprising:

a handle;

an elongate tissue capture member extending from the handle, wherein the tissue capture member has a longitudinal axis and comprises a free end distal the handle;

wherein the free end of the tissue capture member includes a tip, a tissue capture recess, and at least one slot extending through the free end in the tissue capture recess;

an elongate tubular cutting member coupled to the handle, wherein the cutting member slidingly and coaxially receives the tissue capture member;

wherein the cutting member has a free end distal the handle that includes a cutting.

2. The device of claim 1 wherein the cutting member has an open position with the free end of the cutting member axially withdrawn from the tissue capture recess, and a closed position with the free end of the cutting member extending across the tissue capture recess.

3. The device of claim 2 wherein the cutting edge is adapted to shear tissue extending into the tissue capture recess when the cutting member is transitioned from the open position to the closed position.

4. The device of claim 1 wherein the at least one slot is elongate and is oriented perpendicular to the longitudinal axis of the tissue capture member.

5. The device of claim 4, wherein the at least one slot is rectangular.

6. The device of claim 1 wherein the free end of the tissue capture member comprises a plurality of slots extending through the free end in the tissue capture recess.

7. The device of claim 6 wherein each slot in the tissue capture member is elongate and is oriented perpendicular to the longitudinal axis of the tissue capture member.

8. The device of claim 7 wherein the slots are uniformly axially spaced apart.

9. The device of claim 1 wherein the tip of the tissue capture member is dome-shaped.

10. The device of claim 4 wherein the free end of the tissue cutting member comprises at least one slot extending through the upper portion of the free end.

11. The device of claim 10 wherein the at least one slot in the free end of the tissue cutting member is elongate and is oriented perpendicular to the at least one slot in the tissue capture member.

12. The device of claim 2 wherein the handle includes an internal spring that biases the cutting member to the open position.

13. A method for treating stenosis of a neural foramen of a patient comprising:

a) visualizing the neural foramen;

b) outlining a nerve or nerve root in the region of interest with a contrast agent;

c) percutaneously positioning a distal end of a portal proximal the neural foramen to be excised;

d) inserting a tissue excision device into a proximal end of the portal external the patient;

c) advancing the tissue excision device through the portal to the neural foramen; and

d) modifying the neural foramen with the tissue excision device.

14. The method of claim 13 wherein visualizing the neural foramen comprises:

orienting a first fluoroscopic imaging line substantially perpendicular to the dorsal skin of the patient, and

orienting a second fluoroscopic imaging line at a caudal-cranial angle between 5° and

30° and

at a lateral-oblique angle between about 15° and

60°

15. The method of claim 14 wherein the neural foramen is defined by a vertebral body, a pedicle, a superior articular process of an inferior vertebra, and an inferior articular process of a superior vertebra, and wherein modifying the neural foramen comprises excising tissue from the vertebral body, the pedicle, the superior articular process of the inferior vertebra, or the inferior articular process of the superior vertebra.

16. The method of claim 15 wherein the tissue excision device comprises:

an elongate tissue capture member having a longitudinal axis and free end with a tissue capture recess;

an elongate tubular cutting member coaxially disposed about the elongate member, wherein the cutting member includes a free end having a cutting edge; and

wherein the cutting member has an open position with the free end axially withdrawn from the tissue capture recess, and a closed position with the free end extending across the tissue capture recess.

17. The method of claim 16 further comprising:

configuring the tissue excision device into the open position;

positioning a portion of the vertebral body, the pedicle, the superior articular process of the inferior vertebra, or the inferior articular process of the superior vertebra in the tissue capture recess;

transitioning the cutting member to the closed position; and

shearing the portion of the vertebral body, the pedicle, the superior articular process of the inferior vertebra, or the inferior articular process of the superior vertebra extending into the tissue capture recess.

18. The method of claim 16 wherein the free end of the tissue capture member includes at least one elongate slot disposed extending through the free end in the tissue capture recess.

19. The method of claim 18 wherein the at least one slot is oriented perpendicular to the longitudinal axis.

20. The method of claim 16 wherein the free end of the tissue capture member has a dome-shaped tip.

21. The method of claim 17 wherein the tissue cutting member includes an elongate slot in the upper portion of the free end, wherein the slot is oriented parallel to the longitudinal axis.