TISSUE REMOVAL DEVICE FOR USE WITH IMAGING DEVICES IN NEUROSURGICAL AND SPINAL SURGERY APPLICATIONS

• US 20100152533A1
• Filed: 02/20/2009
• Published: 06/17/2010
• Est. Priority Date: 12/16/2008
• Status: Active Grant

• Current Assignee: NICO Corporation
• Original Assignee: NICO Corporation
• Inventors: Mark, Joseph L.
• Granted Patent: US 9,655,639 B2
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/00738 part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 90/20 Surgical microscopes characterised by non-optical aspects
• CPC Class Codes: A61M 1/79 Filters for solid matter specially adapted for dental use A61C17/065

Abstract

A tissue cutting device that is especially suited for neurosurgical applications is disclosed and described. The device includes a handpiece and an outer cannula in which a reciprocating inner cannula is disposed. The inner cannula includes a hinge between a body section and a cutting section that allows the cutting section to pivot when the inner cannula reciprocates within the outer cannula. A tissue collector is also provided and is in fluid communication with the lumen of the inner cannula. The tissue cutting device may be used with imaging device such as microscopes and endoscopes during neurosurgery procedures.

Claims

1. A method of performing a neurosurgical procedure, comprising:

providing an imaging device;

providing a tissue removal device comprising;

a handpiece,

an outer cannula having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue,

an inner cannula disposed in the outer cannula lumen and reciprocable within the outer cannula lumen, the inner cannula having an inner cannula lumen, a proximal end, a distal end, a cutting edge at the distal end, a living hinge, a cutting section, and a body section, with the hinge being located between the cutting section and the body section, wherein the cutting section is pivotable when the inner cannula reciprocates within the outer cannula lumen, and

a tissue collector in fluid communication with the inner cannula lumen;

positioning the imaging device relative to a target tissue associated with the patient'"'"'s neurological system such that the target tissue can be viewed with the imaging device and such that the imaging device and the target tissue define a space between the imaging device and the target tissue;

positioning the outer cannula opening of the tissue removal device in the space such that the outer cannula opening is disposed proximate the target tissue;

viewing the target tissue and the outer cannula of the tissue removal device with the imaging device; and

reciprocating the inner cannula within the outer cannula lumen between a proximal position and a distal position, such that when the inner cannula is in the proximal position, the target tissue is received in the outer cannula opening, and when the inner cannula moves towards the distal position, the cutting section pivots and the received target tissue is severed from surrounding tissue.

2. The method of claim 1, wherein the step of positioning the outer cannula opening of the tissue removal device in the space comprises positioning the tissue removal device such that the entire outer cannula is disposed between the imaging device and the target tissue along the direction defined between the imaging device and the target tissue.

3. The method of claim 1, wherein the step of positioning the outer cannula opening of the tissue removal device in the space comprises positioning the tissue removal device such that the entire tissue removal device is disposed between the imaging device and the target tissue along the direction defined between the imaging device and the target tissue.

4. The method of claim 1, further comprising providing a tissue removal assembly comprising a trocar, the imaging device, and the tissue removal device, wherein at least a portion of the imaging device and at least a portion of the tissue removal device are disposed in the trocar.

5. The method of claim 4, wherein the trocar comprises a trocar shaft having a working channel and an imaging device channel, the imaging device comprises an imaging device shaft, the imaging device shaft is at least partially disposed in the imaging device channel, and the outer cannula of the tissue removal device is at least partially disposed in the working channel.

6. The method of claim 1, wherein the step of viewing the target tissue with the imaging device comprises first viewing the target tissue with the imaging device prior to the reciprocating step, and the method further comprises second viewing the target tissue with the imaging device during the reciprocating step.

7. The method of claim 1, wherein the target tissue comprises a lesion.

8. The method of claim 1, wherein the target tissue is spinal tissue.

9. The method of claim 1, wherein the target tissue is brain tissue.

10. The method of claim 1, wherein the target tissue comprises a tumor.

11. The method of claim 1 wherein the imaging device is a microscope.

12. The method of claim 1, wherein the imaging device is an endoscope.

13. The method of claim 1, wherein the tissue removal device comprises a motor disposed in the handpiece, and the motor has a rotating shaft that is substantially parallel to the inner cannula and spaced apart from the inner cannula.

14. The method of claim 1, further comprising aspirating severed target tissue from the inner cannula distal end to the inner cannula proximal end.

15. The method of claim 1, further comprising generating a vacuum in the inner lumen.

16. The method of claim 1, further comprising stopping the reciprocation of the inner cannula within the outer cannula and applying a vacuum to the inner cannula lumen to aspirate fluids or tissue associated with a neurosurgical procedure through the inner cannula while the inner cannula is not reciprocating.

17. The method of claim 16, wherein the steps of stopping the reciprocation of the inner cannula within the outer cannula and applying a vacuum to the inner cannula lumen are performed without removing the outer cannula from the space.

18. The method of claim 16, wherein the step of stopping the reciprocation of the inner cannula within the outer cannula comprises stopping the inner cannula at a selected position with respect to the outer cannula opening.

19. The method of claim 16, wherein the step of applying a vacuum level to the inner cannula lumen comprises varying the vacuum level in the inner cannula lumen.

20. A method of performing a neurosurgical procedure, comprising:

providing an endoscope;

providing a tissue removal device comprising;

a handpiece,

an outer cannula having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue,

an inner cannula disposed in the outer cannula lumen and reciprocable within the outer cannula lumen, the inner cannula having an inner cannula lumen, a proximal end, a distal end, a cutting edge at the distal end, a living hinge, a cutting section, and a body section with the hinge being located between the cutting section and the body section, wherein the cutting section is pivotable when the inner cannula reciprocates within the outer cannula lumen, and

a tissue collector in fluid communication with the inner cannula lumen;

positioning the endoscope relative to a target tissue associated with the patient'"'"'s neurological system such that the target tissue can be viewed with the endoscope and such that the endoscope and the target tissue define a space between the endoscope and the target tissue;

gripping the handpiece with a single hand and positioning the outer cannula of the tissue removal device such that the outer cannula opening is proximate the target tissue;

viewing the target tissue with the endoscope; and

reciprocating the inner cannula within the outer cannula lumen between a proximal position and a distal position, such that when the inner cannula is in the proximal position, the target tissue is received in the outer cannula opening, and when the inner cannula moves towards the distal position, the cutting section pivots and the received tissue is severed from surrounding tissue.

21. The method of claim 20, wherein the endoscope has an eyepiece, an endoscope shaft, and a longitudinal axis, and the method further comprises positioning the tissue removal device at a location that is between the eyepiece and the target tissue along the direction of the longitudinal axis of the endoscope.

22. The method of claim 20, further comprising the step of rotating the outer cannula of the tissue cutting device about the outer cannula longitudinal axis to position the outer cannula opening proximate the target tissue.

23. The method of claim 22, wherein the tissue cutting device further comprises a rotation dial operatively connected to the outer cannula such that when the rotation wheel is rotated, the outer cannula rotates about the outer cannula longitudinal axis.

24. The method of claim 20, wherein the handpiece has a lower housing, and the longitudinal axis of the handpiece lower housing is parallel to and spaced apart from the longitudinal axis of the inner cannula.

25. The method of claim 20, wherein the step of viewing the target tissue with the endoscope comprises first viewing the target tissue with the endoscope prior to the reciprocating step, and the method further comprises second viewing the target tissue with the endoscope during the reciprocating step.

26. The method of claim 20, further comprising providing a trocar having a trocar shaft with a working channel and an endoscope channel, wherein the endoscope comprises an endoscope shaft, and the method further comprises removably inserting the outer cannula into the working channel such that the distal end of the outer cannula projects through and away from the working channel and removably inserting the endoscope shaft into the endoscope channel.

27. The method of claim 20, wherein the target tissue comprises a lesion.

28. The method of claim 20, wherein the target tissue is a brain tissue.

29. The method of claim 20, wherein the target tissue is a spinal tissue.

30. The method of claim 20, wherein the target tissue comprises a tumor.

31. The method of claim 20, further comprising stopping the reciprocation of the inner cannula within the outer cannula and applying a vacuum to the inner cannula lumen to aspirate fluids or tissue associated with a neurosurgical procedure through the inner cannula while the inner cannula is not reciprocating.

32. The method of claim 31, wherein the steps of stopping the reciprocation of the inner cannula within the outer cannula and applying a vacuum to the inner cannula lumen are performed without removing the outer cannula from the space.

33. The method of claim 31, wherein the step of stopping the reciprocation of the inner cannula within the outer cannula comprises stopping the inner cannula at a selected position with respect to the outer cannula opening.

34. The method of claim 31, wherein the step of applying a vacuum level to the inner cannula lumen comprises varying the vacuum level in the inner cannula lumen.

35. A neurosurgical tissue removal assembly, comprising:

an endoscope with an endoscope shaft;

a trocar having a shaft with a working channel and an endoscope channel; and

a tissue removal device, wherein the tissue removal device comprises;

a handpiece,

an outer cannula having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue, and the outer cannula is removably insertable into the working channel,

an inner cannula disposed in the outer cannula lumen and reciprocable within the outer cannula lumen, the inner cannula having an inner cannula lumen, a proximal end, an open distal end, a cutting edge at the distal end, a living hinge, a cutting section, and a body section, with the hinge being located between the cutting section and the body section, wherein the cutting section is pivotable when the inner cannula reciprocates within the outer cannula lumen, and

a tissue collector in fluid communication with the inner cannula lumen, wherein at least a portion of the outer cannula is disposed in the working channel and at least a portion of the endoscope shaft is disposed in the endoscope channel.

36. The neurosurgical tissue removal assembly claim 35, wherein the outer cannula is removably inserted into the working channel such that the distal end of the outer cannula projects away from the trocar shaft.

37. The neurosurgical tissue removal assembly of claim 35, wherein the handpiece has a lower housing having a longitudinal axis, the inner cannula has a longitudinal axis, and the longitudinal axis of the handpiece lower housing is not collinear with the longitudinal axis of the inner cannula.

38. The neurosurgical tissue removal assembly of claim 37, wherein the longitudinal axis of the handpiece lower housing is parallel to and spaced apart from the inner cannula longitudinal axis.

39. The neurological tissue removal assembly of claim 35, wherein the tissue cutting device handpiece is spaced apart from the trocar.

40. The neurological tissue removal assembly of claim 35, wherein the endoscope eyepiece is located between the trocar and the handpiece in a direction along the length of the endoscope.

41. The neurological tissue removal assembly of claim 35, further comprising a motor disposed in the tissue removal device handpiece, wherein the motor has a rotating shaft that is substantially parallel to and spaced apart from the inner cannula.

42. The neurological tissue removal assembly of claim 35, further comprising a tissue aspiration path from the inner cannula distal end to the inner cannula proximal end.

43. The neurological tissue removal assembly of claim 35, further comprising a vacuum generator in fluid communication with the inner cannula lumen.

44. A method of performing a neurosurgical procedure, comprising:

providing the neurosurgical assembly of claim 35;

positioning the trocar shaft relative to a target tissue associated with the patient'"'"'s neurological system such that the target tissue can be viewed with the endoscope;

gripping the assembly with a single hand and positioning the outer cannula of the tissue removal device such that the outer cannula opening is proximate the target tissue;

viewing the target tissue with the endoscope; and

reciprocating the inner cannula within the outer cannula lumen between a proximal position and a distal position, such that when the inner cannula is in the proximal position, the target tissue is received in the outer cannula opening, and when the inner cannula is in the distal position, the cutting section pivots and the received tissue is severed from surrounding tissue.

45. The method of claim 44, further comprising stopping the reciprocation of the inner cannula within the outer cannula and applying a vacuum to the inner cannula lumen to aspirate fluids associated with a neurosurgical procedure through the inner cannula while the inner cannula is not reciprocating.

46. The method of claim 45, wherein the steps of stopping the reciprocation of the inner cannula within the outer cannula and applying a vacuum to the inner cannula lumen are performed without removing the outer cannula from the working channel.

47. The method of claim 45, wherein the step of stopping the reciprocation of the inner cannula within the outer cannula comprises stopping the inner cannula at a selected position with respect to the outer cannula opening.

48. The method of claim 45, wherein the step of applying a vacuum level to the inner cannula lumen comprises varying the vacuum in the inner cannula lumen.