Tissue Excision Tool, Kits and Methods of Using the Same

• US 20090118709A1
• Filed: 10/29/2008
• Published: 05/07/2009
• Est. Priority Date: 11/06/2007
• Status: Abandoned Application

• Current Assignee: Vertos Medical, Inc.
• Original Assignee: Vertos Medical, Inc.
• Inventors: Sand, Paul, Way, Bryce
• Application Number:
  US12/260,311
• Publication Number:
  US 20090118709A1
• Time in Patent Office: Days
• US Class Current: 604/540
• CPC Class Codes: A61B 17/149 Chain, wire or band saws
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1671 for the spine
• 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 17/320758 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 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw

Abstract

An invention is disclosed that describes devices, kits and methods for providing percutaneous access to a surgical site. Suitable devices comprise a hollow body having a distal end and a proximal end, wherein the distal end comprises one or more apertures; a first pivot member disposed within the hollow body; and a tissue excision member mounted in rotatable communication with the pivot member, wherein at least a portion of the tissue excision member is exposed through the one or more side apertures, and wherein the tissue excision member moves in a longitudinal direction around the pivot member in relation to the hollow body.

Claims

1. A device for providing percutaneous access to a surgical site, comprising:

a hollow body having a distal end and a proximal end, wherein the distal end comprises one or more apertures;

a first pivot member disposed within the hollow body; and

a tissue excision member mounted in rotatable communication with the pivot member, wherein at least a portion of the tissue excision member is exposed through the one or more side apertures, and wherein the tissue excision member moves in a longitudinal direction around the pivot member in relation to the hollow body.

2. The device of claim 1 wherein the tissue excision member comprises an abrasive or cutting surface.

3. The device of claim 1 wherein the hollow body is cylindrical.

4. The device of claim 1 wherein the distal end comprises more than one aperture.

5. The device of claim 1 wherein the distal end is angled to form a sharpened tip.

6. The device of claim 1 further comprising a handle coupled to the hollow body.

7. The device of claim 6 further comprising an actuator coupled to a second pivot member wherein the second pivot member is in communication with the first pivot member.

8. The device of claim 6 wherein the actuator is a motor.

9. The device of claim 8 wherein the motor is disposed within the handle.

10. A method for treating stenosis in a spine of a patient having a median plane comprising the steps of:

(a) compressing a dural sac in the region of interest by injecting a fluid to form a safety zone and establish a working zone in the region of interest, the safety zone lying between the working zone and the dural sac;

(b) percutaneously accessing an epidural space in the region of interest on a first lateral side of a median plane; and

(c) inserting a tissue excision device comprising a hollow body having a distal end and a proximal end, wherein the distal end comprises one or more apertures;

a first pivot member disposed within the hollow body; and

a tissue excision member mounted in rotatable communication with the pivot member, wherein at least a portion of the tissue excision member is exposed through the one or more side apertures, and wherein the tissue excision member moves in a longitudinal direction around the pivot member in relation to the hollow body into a tissue in the working zone on the first lateral side of the median plane.

11. The method of claim 10 further comprising the step of generating at least one view of a portion of a spinal canal in a region of interest.

12. The method of claim 11 further comprising using the at least one view to position the tissue excision device during at least part of the step of inserting.

13. The method of claim 10 wherein a portion of a patient'"'"'s ligamentum flavum occupies the working zone in the region of interest.

14. The method of claim 10 further comprising the step of using the tissue excision device to percutaneously reduce a stenosis on the first lateral side of the median plane.

15. The method of claim 14 further comprising using the at least one view to position the tissue excision device during at least part of the step of using the tissue excision device.

16. The method step of claim 11 further comprising the step of removing at least a portion of the ligamentum flavum in the region of interest.

17. The method of claim 10 further comprising the step of using the tissue excision device to percutaneously reduce a stenosis on a second lateral side of the median plane different than the first lateral side.

18. The method of claim 17 further comprising using the at least one view to position the tissue excision device during at least part of the step of using the tissue excision device.

19. A device for providing percutaneous access to a surgical site, comprising:

a hollow body having a distal end and a proximal end, wherein the distal end comprises one or more side apertures;

a distal pivot member disposed within the distal end and a proximal pivot member disposed within the proximal end; and

a tissue excision belt rotatably mounted on the distal pivot member and the proximal pivot member, wherein at least a portion of the tissue excision belt is exposed through the one or more side apertures, and wherein the tissue excision belt moves in a longitudinal direction around distal pivot member and proximal pivot member in relation to the hollow body.

20. The device of claim 19 wherein the tissue excision belt comprises an abrasive or cutting surface.

21. The device of claim 19 wherein the hollow body is cylindrical.

22. The device of claim 19 wherein the distal end comprises more than one side apertures.

23. The device of claim 19 wherein the distal end is angled to form a sharpened tip.

24. The device of claim 19 further comprising a handle coupled to the hollow body.

25. The device of claim 24 further comprising a motor coupled to the proximal pivot member.

26. The device of claim 25 wherein the motor is disposed within the handle.

27. A method for treating stenosis in a spine of a patient having a median plane comprising the steps of:

(a) compressing a dural sac in the region of interest by injecting a fluid to form a safety zone and establish a working zone in the region of interest, the safety zone lying between the working zone and the dural sac;

(b) percutaneously accessing an epidural space in the region of interest on a first lateral side of a median plane; and

(c) inserting a tissue excision device comprising a hollow body having a distal end and a proximal end, wherein the distal end comprises one or more side apertures, a distal pivot member disposed within the distal end and a proximal pivot member disposed within the proximal end, and a tissue excision belt rotatably mounted on the distal pivot member and the proximal pivot member, wherein at least a portion of the tissue excision belt is exposed through the one or more side apertures, and wherein the tissue excision belt moves in a longitudinal direction around distal pivot member and proximal pivot member in relation to the hollow body.

28. The method of claim 27 further comprising the step of generating at least one view of a portion of a spinal canal in a region of interest.

29. The method of claim 28 further comprising using the at least one view to position the tissue excision device during at least part of the step of inserting.

30. The method of claim 27 wherein a portion of a patient'"'"'s ligamentum flavum occupies the working zone in the region of interest.

31. The method of claim 27 further comprising the step of using the tissue excision device to percutaneously reduce a stenosis on the first lateral side of the median plane.

32. The method of claim 31 further comprising using the at least one view to position the tissue excision device during at least part of the step of using the tissue excision device.

33. The method step of claim 28 further comprising the step of removing at least a portion of the ligamentum flavum in the region of interest.

34. The method of claim 27 further comprising the step of using the tissue excision device to percutaneously reduce a stenosis on a second lateral side of the median plane different than the first lateral side.

35. The method of claim 34 further comprising using the at least one view to position the tissue excision device during at least part of the step of using the tissue excision device.

36. A kit for tissue excisions comprising:

a device having a hollow body having a distal end and a proximal end, wherein the distal end comprises one or more apertures;

a first pivot member disposed within the hollow body; and

a tissue excision member mounted in rotatable communication with the pivot member, wherein at least a portion of the tissue excision member is exposed through the one or more side apertures, and wherein the tissue excision member moves in a longitudinal direction around the pivot member in relation to the hollow body; and

packaging.

37. The kit of claim 36 further comprising an injectable medium.

38. The kit of claim 37 wherein the injectable medium is a contrast medium.

39. The kit of claim 38 wherein the contrast medium is a hydrophillic-lipophillic block copolymer gel.

40. The kit of claim 38 further comprising a guide adaptable for use with the device.