Surgical cutting instrument for coring tissue affixed thereto

• US 5,488,958 A
• Filed: 11/07/1994
• Issued: 02/06/1996
• Est. Priority Date: 11/09/1992
• Status: Expired due to Term

• Current Assignee: Cook Medical Technologies, LLC (Cook Group Incorporated)
• Original Assignee: Vance Products Incorporated (Cook Group Incorporated)
• Inventors: Foster, Thomas L., Topel, Howard C.
• Primary Examiner(s): Graysay, Tamara L.
• Application Number:
  US08/335,221
• Time in Patent Office: 456 Days
• Field of Search: 606/180, 606/184, 128/754, 128/751, 30/361, 30/113.1, 30/113.2
• US Class Current: 600/567
• CPC Class Codes: A61B 10/0266 means for severing sample
• 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 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/320024 Morcellators, e.g. having a hollow cutting tube with an annular cutter for morcellating and removing tissue
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue

Abstract

A surgical cutting instrument for coring, debulking, and removing a large, tough tissue mass such as a fibroid tumor through a trocar access sheath during a minimally invasive surgical procedure. The instrument includes an outer sheath having a distal cutting end for coring the tissue mass and an inner elongated member having a distal, tissue affixation end such as a helical coil for inserting into and stabilizing the tissue mass during the surgical coring procedure. The cutting instrument further includes an instrument engagement assembly when in an engaged position for urging the outer sheath toward the distal end of the inner elongated member. As a result, tissue affixed to the distal end of the inner elongated member is cored as the outer sheath is urged toward the distal end of the inner member and engages the affixed tissue. The instrument engagement assembly includes sheath and member engagement subassemblies. The sheath engagement subassembly is positioned about the proximal end of the outer sheath and includes a hub with a pivotedly interconnected side arm. The member engagement subassembly positioned along the intermediate portion of the inner member includes multiple start helical threads. The side arm has projections extending laterally therefrom for extension into the passage of the hub and engaging the multiple start helical threads of the inner member.

Claims

1. A surgical cutting instrument comprising:

an outer sheath having a distal cutting end, a proximal end, and a passage extending longitudinally therethrough;

an elongated member at least part of which can be inserted through said passage of said outer sheath and having a distal end extendable from said distal cutting end of said outer sheath when positioned in said passage of said outer sheath, said distal end of said elongated member having a part fixable in tissue; and

assembly means positioned on at least one of said outer sheath and said elongated member for rotating said outer sheath and moving said distal cutting end thereof toward said distal end of said elongated member when said distal end of said elongated member is extended from said distal cutting end of said outer sheath and retained in a fixed position with tissue affixed thereto, whereby forward and rotational movement of said outer sheath causes said distal cutting end to rotate and core tissue affixed to said distal end of said elongated member;

wherein said assembly means includes sheath engagement means positioned on said outer sheath and member engagement means positioned on said elongated member for selectively engaging each other;

wherein said sheath engagement means includes a hub attached about said proximal end of said outer sheath and having a passage communicating with said passage of said outer sheath;

wherein said member engagement means includes positioning means for controlling the position of said elongated member in said passage of said outer sheath;

wherein said sheath engagement means further includes selector means attached to said hub for selectively engaging said positioning means;

wherein said positioning means includes an intermediate portion of said elongated member having an outer surface and a helical groove in said outer surface; and

wherein said selector means comprises an arm slidably attached to said hub, said arm having a slot therethrough communicating with said passage of said hub, said slot having a plurality of at least partial grooves mating with said helical groove of said proximal portion of said elongated member when said instrument engagement means is in said predetermined position.

2. A surgical cutting instrument comprising:

an outer sheath having a distal cutting end, a proximal end, and a passage extending longitudinally therethrough;

an elongated member at least part of which can be inserted through said passage of said outer sheath and having a distal end extendable from said distal cutting end of said outer sheath when positioned in said passage of said outer sheath, said distal end of said elongated member having a part fixable in tissue;

a hub attached about said proximal end of said outer sheath and having a passage communicating with said passage of said outer sheath and at least one projection positioned in said passage of said hub when in a predetermined position; and

an intermediate portion of said member having an outer surface and a helical groove in said outer surface engaging said at least one projection, said at least one projection and said helical groove for rotating said outer sheath and moving said distal cutting end toward said distal end of said elongated member when said distal end of said elongated member is extended from said distal cutting end of said outer sheath and retained in a fixed position with tissue affixed thereto, whereby forward and rotational movement of said outer sheath causes said distal cutting end to rotate and core tissue affixed to said distal end of said elongated member;

wherein said hub includes a side arm pivotedly connected thereto and having said at least one projection extending laterally therefrom and into said passage of said hub when in said passage of said hub when in said predetermined position; and

wherein said hub includes a sleeve fixedly positioned longitudinally and rotatably positioned around a proximal end thereof.

3. The instrument of claim 2 wherein said sleeve includes a thumb rest positioned on an outer surface of said sleeve.

4. The instrument of claim 3 wherein said thumb rest includes a finger pull.

5. A method of coring biological tissue comprising the steps of:

introducing an elongated member through a tube towards the tissue, the tube having a cutting mechanism at its distal end thereof, and the member having tissue attachment means at its distal end;

affixing the attachment means to a first tissue;

moving the cutting mechanism into the tissue with longitudinal and rotary movement relative to the first fixed tissue, whereby the first fixed tissue is cored and retained within the distal end of the tube;

simultaneously withdrawing the attachment means and the distal end of the tube from the tissue;

moving the attachment means and the tube to another site;

affixing the attachment means to a second tissue at said other site; and

moving the cutting mechanism into the tissue at said other site with longitudinal and rotary movement relative to the second fixed tissue, whereby the second fixed tissue is cored and retained within the distal end of the tube distally of the first fixed tissue.