DEVICES AND METHODS FOR CUTTING AND EVACUATING TISSUE

• US 20120004595A1
• Filed: 06/30/2011
• Published: 01/05/2012
• Est. Priority Date: 06/30/2010
• Status: Active Grant

• Current Assignee: Myromed, LLC
• Original Assignee: Laurimed, LLC
• Inventors: NIELSEN, James T., DUBOIS, Brian R., GORDON, Alexander
• Granted Patent: US 8,298,254 B2
• Time in Patent Office: Days
• US Class Current: 604/22
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00269 endoscopic mucosal resection EMR
• CPC Class Codes: A61B 2017/00561 creating a vacuum
• CPC Class Codes: A61B 2017/320008 Scrapers
• CPC Class Codes: A61B 2017/320028 with reciprocating movements
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means

Abstract

Various medical devices and methods for cutting and/or evacuating tissue are provided. The devices and methods may utilize a reciprocating mechanism or motor powered by suction from a vacuum source. The medical devices and methods may be used on tissue in various regions of a patient'"'"'s body and for treating various conditions, e.g., for performing a polypectomy or discectomy.

Claims

1. A vacuum powered tissue cutting device comprising:

an elongate shaft having a proximal end, a distal end and a lumen defined therein, wherein the distal end has an opening for receiving tissue;

a cutter positioned within the elongate shaft, wherein the cutter is configured to be reciprocated to cut tissue;

a chamber coupled to the proximal end of the elongate shaft such that the elongate shaft remains fixed relative to the chamber, the chamber having a mechanism positioned therein, wherein the mechanism is powered by suction created by a vacuum source such that the mechanism produces a reciprocating motion which causes the cutter to reciprocate.

2. The device of claim 1, wherein the mechanism is powered solely by suction created by the vacuum source.

3. The device of claim 1, wherein suction from the vacuum source draws tissue into the opening

4. The device of claim 1, wherein the cutter is configured to reciprocate past the opening in the elongate shaft to cut the tissue in the opening.

5. The device of claim 1, wherein the device is configured such that cut tissue is evacuated through an evacuation lumen in the elongate shaft by suction created by the vacuum source.

6. The device of claim 1, wherein the device is configured to receive suction from a single vacuum source which supplies suction for evacuation and for powering the mechanism.

7. The device of claim 1, wherein the elongate shaft has a lumen for delivering irrigant to the distal end of an evacuation lumen in the elongate shaft, wherein the irrigant does not flow through the lumen unless suction from the vacuum source is present to draw the irrigant through the lumen.

8. The device of claim 1, wherein the chamber is in the form of an ergonomic handle.

9. The device of claim 8, wherein the handle is positioned at an angle relative to the elongate shaft thereby providing a clear line of site above and/or to the side of the elongate shaft.

10. The device of claim 1, wherein the chamber and mechanism are positioned at an angle relative to the elongate shaft, wherein the mechanism is connected to the cutter and the mechanism reciprocates the cutter in a rectilinear motion.

11. The device of claim 1, wherein a tissue collection chamber is integrated in the device such that removal of the chamber disables the device

12. The device of claim 1, wherein the distal end of the shaft includes a malleable portion, wherein the cutter is reciprocated within the malleable portion.

13. The device of claim 1, wherein the mechanism is powered by vacuum available in a physician'"'"'s office.

14. The device of claim 1, wherein the cutter is a cutting blade and the cutting blade is not exposed on an outside of the opening to provide safety to patients.

15. The device of claim 1, wherein the vacuum powered mechanism reciprocates at a rate of less than about 1200 cycles/min.

16. The device of claim 1, wherein the speed of the cutter ranges from 250-2500 cycles/min.

17. The device of claim 1, wherein the mechanism comprises a piston, wherein the suction is applied to both sides of a piston in an alternating manner to cause the piston to reciprocate which causes the cutter to reciprocate.

18. The device of claim 17, wherein the mechanism comprises a first piston and a second piston, wherein the first piston is coupled to the second piston by a bi-stable switch which translates motion from the first piston to the second piston.

19. The device of claim 1, further comprising an electrocautery wire positioned at the distal end of the elongate shaft.

20. The device of claim 1, further comprising a lumen in the elongate shaft for delivering an anticoagulation therapy.

21. The device of claim 1, wherein the device is fully disposable.

22. A vacuum powered tissue cutting device comprising:

an elongate shaft having a proximal end, a distal end and a lumen defined therein, wherein the distal end has an opening for receiving tissue;

a cutter positioned within the elongate shaft, wherein the cutter is configured to be reciprocated past the opening in the elongate shaft to cut tissue in the opening;

a chamber coupled to the proximal end of the elongate shaft, the chamber having a cutter driver assembly positioned therein, wherein the cutter driver assembly is powered by suction created by a vacuum source such that the cutter driver assembly produces a reciprocating motion which causes the cutter to reciprocate.

23. A method of cutting and removing tissue from a subject comprising:

advancing a cutting device next to a target tissue in the subject, the cutting device having an elongate shaft and a cutter positioned within the elongate shaft;

powering the cutting device using suction created by a vacuum source such that the cutting device produces a reciprocating motion which causes the cutter to reciprocate;

cutting tissue with the reciprocating cutter; and

evacuating the cut tissue using the suction created by the vacuum source.

24. The method of claim 23, further comprising drawing target tissue into an opening in the elongate shaft using suction from the vacuum source, wherein the cutter is configured to be reciprocated past the opening in the elongate shaft to cut tissue in the opening.

25. The method of claim 23, wherein the proximal end of the elongate shaft is coupled to a handle such that the elongate shaft remains fixed relative to the handle while the cutter is being reciprocated

26. The method of claim 23, wherein the cutting device is powered solely by suction created by the vacuum source.

27. The method of claim 23, wherein the cut tissue is evacuated through an evacuation lumen in the elongate shaft by suction created by the vacuum source.

28. The method of claim 23, wherein suction is received from a single vacuum source which supplies suction for evacuation and for reciprocating the cutter.

29. The method of claim 23, further comprising delivering irrigant to the distal end of an evacuation lumen in the elongate shaft, wherein the irrigant does not flow through the lumen unless suction from the vacuum source is present to draw the irrigant through the lumen.

30. The method of claim 23, wherein the cutting device comprises a handle positioned at an angle relative to the elongate shaft thereby providing a clear line of site above and/or to the side of the elongate shaft.

31. The method of claim 23, wherein a cutting device comprises a tissue collection chamber and removal of the chamber disables the device

32. The method of claim 23, wherein the elongate shaft includes a malleable portion and the cutter is reciprocated within the malleable portion.

33. The method of claim 23, wherein the cutting device is powered by vacuum available in a physician'"'"'s office.

34. The method of claim 23, wherein the vacuum powered cutting device comprises a mechanism that reciprocates at a rate of less than about 1200 rpm.

35. The method of claim 23, wherein the speed of the cutter ranges from 250-2500 cycles/min).

36. The method of claim 23, wherein the vacuum powered cutting device comprises a piston, wherein the suction is applied to both sides of a piston in an alternating manner to cause the piston to reciprocate which causes the cutter to reciprocate.

37. The method of claim 36, wherein the cutting device comprises a first piston and a second piston, wherein the first piston is coupled to the second piston by a bi-stable switch which translates motion from the first piston to the second piston.

38. The method of claim 23, further comprising treating bleeding with an electrocautery wire positioned at the distal end of the elongate shaft.

39. The method of claim 23, further comprising delivering an anticoagulation therapy to a tissue site via the elongate shaft.

40. The method of claim 23, wherein the cutting device is fully disposable.

41. The method of claim 23, wherein the tissue is a polyp.

42. The method of claim 23, wherein the tissue is intradiscal nucleus.

43. A method for performing a polypectomy comprising:

advancing a cutting device next to a polyp in a subject;

powering the cutting device using suction created by a vacuum source such that the cutting device produces a reciprocating motion which causes the cutter to reciprocate or rotate; and

cutting the polyp with the reciprocating or rotating cutter.

44. The method of claim 43, further comprising evacuating the cut polyp using the suction created by the vacuum source.

45. The method of claim 43, wherein the cutting device is powered solely by suction created by the vacuum source.

46. A method for performing a discectomy comprising:

advancing a cutting device into a disc in a spine of a subject;

powering the cutting device using suction created by a vacuum source such that the cutting device produces a reciprocating motion which causes the cutter to reciprocate or rotate; and

cutting a nucleus of the disc with the reciprocating or rotating cutter.

47. The method of claim 46, further comprising evacuating the cut disc or nucleus using the suction created by the vacuum source.

48. The method of claim 46, wherein the cutting device is powered solely by suction created by the vacuum source.

49. An apparatus for scraping tissue in a subject comprising:

an end effector, wherein the end effector includes a scraping edge positioned on a distal end of the end effector and one or more scraping wings positioned at an angle relative to the scraping edge such that the scraping edge and scraping wings may be used to provide scraping motions in different directions.