Irrigating, cutting and aspirating system for percutaneous surgery

• US 4,678,459 A
• Filed: 07/23/1984
• Issued: 07/07/1987
• Est. Priority Date: 07/23/1984
• Status: Expired

• Current Assignee: Surgical Dynamics Incorporated (Medtronic Plc)
• Original Assignee: E-Z-EM Incorporated (Bracco SPA), Surgical Dynamics Incorporated (Medtronic Plc)
• Inventors: Onik, Gary, Ginsburg, Leonard
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US06/633,514
• Time in Patent Office: 1,079 Days
• Field of Search: 128/305, 128/305.1, 128/751, 128/752, 128/755, 604/22
• 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 2017/2905 flexible

Abstract

A percutaneous discectomy system 10 includes a discectomy device 12 having a needle 16 with a port 48 and a flared cutting edge 44 which is actuated past the port 48 to sever tissue provided adjacent thereto. An irrigation device is 18 are provided for irrigating the area adjacent the tip 46 of the needle 16 to assist a vacuum device 22 in aspirating the severed tissue away from the disc. The discectomy system 10 assists in the removal of herniated disc tissue in order to relieve pressure on the nerves located adjacent thereto. In addition, the needle 16 is flexible so that it can be temporarily or permanently bent around other body tissues such as the pelvis in order to access discs which are surgically hard to reach otherwise.

Claims

1. A surgical instrument comprising:

a housing;

a needle supported by said housing, said needle having a forward portion extending distally of said housing;

said needle including a first elongated tubular wall member defining a first bore, and having a port formed entirely within the sidewall of the forward portion of said first tubular wall member;

said needle including a second elongated tubular wall member defining a second bore sized to permit passage of tissue therethrough when said second tubular wall member is connected to a source of suction, said second tubular wall member having a forward portion extending radially outwardly and terminating in a cutting edge;

said second tubular wall member being positioned within said first tubular wall member with said cutting edge in contact with the sidewall defining said first bore, the forward portion of said first bore adjacent said port defining a tissue receiving portion communicating with said second bore;

said first and second tubular wall members being the only tubular wall members in said forward portion of said needle;

the wall of said second tubular wall member spaced inwardly from the wall of said first tubular wall member to define the opposing walls of an annular passageway adapted to be connected to a source of irrigating fluid, said annular passageway being the sole annular chamber in said forward portion of said needle;

said second tubular wall member being disposed for movement within said first tubular wall member to cause said cutting edge to move from a first position where tissue is drawn through said port into said tissue receiving portion of said first bore under suction to a second position where said cutting edge traverses said port to sever the tissue drawn therethrough, and to permit the severed tissue to be captured in said tissue receiving portion;

said second tubular wall member having an opening formed in its sidewall adjacent said cutting edge to provide internal communication between said annular passageway and said second bore to permit direct passage within said needle of irrigating fluid between said annular passageway and said second bore;

the forward portion of the sidewall of said first tubular wall member having no opening rearward of said cutting edge of said second tubular wall member when said cutting edge is in its first position;

whereby the severed tissue is evacuated through said second bore with the aid of the irrigating fluid.

2. The surgical instrument of claim 1 wherein said first tubular wall member has a cylindrical surface defining said sidewall and a blunt end wall, said port in said sidewall located adjacent said blunt end.

3. The surgical instrument of claim 1 further comprising means for moving said cutting edge of said second tubular wall member between its first and second positions.

4. The surgical instrument of claim 3 wherein said moving means includes a diaphragm associated with said second tubular wall member, and means for exposing said diaphragm to a source of pulsating positive pressure.

5. The surgical instrument of claim 1 further comprising means for providing the irrigating fluid to said annular passageway.

6. The surgical instrument of claim 5 further comprising means for regulating the flow of the irrigating fluid.

7. The surgical instrument of claim 1 further comprising means for providing the source of suction to said second tubular wall member.

8. The surgical instrument of claim 1 wherein the flow of irrigating fluid is "off" when said cutting edge is in its first position and "on" when said cutting edge is in its second position;

9. The surgical instrument of claim 1 further comprising a cannula adapted to receive said first tubular wall member.

10. The surgical instrument of claim 9 wherein said cannula is curved, said first and second tubular wall members being sufficiently flexible to fit within said curved cannula.

11. The surgical instrument of claim 1 whereinn said instrument is a percutaneous discectomy device.

12. A percutaneous discectomy surgical instrument comprising:

a housing;

a needle supported by said housing, said needle having a forward portion extending distally of said housing;

said needle including a second elongated tubular wall member defining a second bore sized to permit passage of tissue therethrough when said second tubular wall member is connected to a source of suction, said second tubular wall member having a forward portion extending radially outwardly and terminating in a cutting edge;

said second tubular wall member being positioned within said first tubular wall member with said cutting edge in contact with the sidewall defining said first bore, the forward portion of said first bore adjacent said port defining a tissue receiving portion communicating with said second bore;

said first and second tubular wall members being the only tubular wall members in said forward portion of said needle;

the wall of said second tubular wall member spaced inwardly from the wall of said first tubular wall member to define the opposing walls of an annular passageway adapted to be connected to a source of irrigating fluid, said annular passageway being the sole annular chamber in said forward portion of said needle;

said second tubular wall member being disposed for movement within said first tubular wall member to cause said cutting edge to move from a first position where tissue is drawn through said port into said tissue receiving portion of said first bore under suction to a second position where said cutting edge tranverses said port to sever the tissue drawn therethrough, and to permit the severed tissue to be captured in said tissue receiving portion;

means for moving said cutting edge of said second tubular wall member between its first and second positions;

said second tubular wall member having an opening formed in its sidewall adjacent said cutting edge to provide internal communication between said annular passageway and said second bore to permit direct passage within said needle of irrigating fluid between said annular passageway and said second bore;

the forward portion of the sidewall of said first tubular wall member having no opening rearward of said cutting edge of said second tubular wall member when said cutting edge is in its first position;

means for providing the irrigating fluid to said annular passageway; and

means for providing the source of suction to said second tubular wall member;

whereby the severed tissue is evacuated through said second bore with the aid of the irrigating fluid.

13. A percutaneous discectomy surgical instrument comprising:

a housing;

a needle supported by said housing, said needle having a forward portion extending distally of said housing;

said needle including a first elongated tubular wall member defining a first bore, and having a port formed entirely within the sidewall of the forward portion of said first tubular wall member;

said needle including a second elongated tubular wall member defining a second bore sized to permit passage of tissue therethrough when said second tubular wall member is connected to a source of suction, said second tubular wall member having a forward portion extending radially outwardly and terminating in a cutting edge;

said second tubular wall member being positioned within said first tubular wall member with said cutting edge in contact with the sidewall defining said first bore, the forward portion of said first bore adjacent said port defining a tissue receiving portion communicating with said second bore;

the wall of said second tubular wall member being spaced inwardly from the wall of said first tubular wall member to define the opposing walls of an annulus, said annulus providing the spacing for the forward portion of said second tubular wall member to extend radially outward and provide a cutting edge, said annulus being the sole annular space in said forward portion of said needle,

a third elongated tubular wall member positioned in said second bore and defining a passageway adapted to be connected to a source of irrigating fluid, said passageway being in communication with said second bore;

said third elongated tubular wall member terminating approximately at said cutting edge of said second tubular wall member to provide direct passage within said needle of fluid between said third tubular wall member and said second bore;

said second tubular wall member being disposed for movement within said first tubular wall member to cause said cutting edge to move from a first position where tissue is drawn through said port into said tissue receiving portion of said first bore under suction to a second position where said cutting edge traverses said port to sever the tissue drawn therethrough, and to permit the severed tissue to be captured in said tissue receiving portion;

the forward portion of the sidewall of said first tubular wall member having no opening rearward of said cutting edge of said second tubular wall member when said cutting edge is in its first position;

whereby the severed tissue is evacuated through said second bore with the aid of the irrigating fluid.