Apparatus and method for removing tissue

• US 5,709,697 A
• Filed: 11/22/1995
• Issued: 01/20/1998
• Est. Priority Date: 11/22/1995
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Marinkovich, Dragomir C., Castro, Salvatore, Ratcliff, Keith
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): RASCHE, PATRICK WILLIAM
• Application Number:
  US08/561,727
• Time in Patent Office: 790 Days
• Field of Search: 606/159, 606/167, 606/170, 606/180, 128/749-754, 600/107
• US Class Current: 606/180
• CPC Class Codes: A61B 10/0266 means for severing sample
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• 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 2017/2215 having an open distal end
• CPC Class Codes: A61B 2017/2937 with flexible part
• CPC Class Codes: A61B 2017/32004 having a laterally movable cutting member at its most distal end which remains within the contours of said end

Abstract

A surgical instrument for cutting tissue, which includes a housing, a cutting element movable between a retracted position disposed substantially within the housing and a deployed position extending outwardly from the housing, a guide member configured and dimensioned to direct orientation of the cutting element, operatively connected to the housing and defining a longitudinal axis, the guide member movable from a first orientation wherein the longitudinal axis of the guide member is aligned with a longitudinal axis of the housing to a second orientation wherein the longitudinal axis of the guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing. A method for surgically removing tissue is also provided and includes the steps of inserting an instrument into an incision formed at the operative site, deploying a blade guide at an angle relative to a longitudinal axis of the instrument, deploying a cutting element from a retracted position to an exposed position such that the cutting element is guided by the blade guide, moving the cutting element through a predetermined path such that a section of tissue is separated from the surrounding tissue, and removing the cut tissue from the surrounding tissue.

Claims

1. A surgical instrument for cutting tissue, which comprises:

a housing;

a cutting blade having a variable configuration movable between a retracted position disposed substantially within the housing wherein the cutting blade assumes a first configuration and a deployed position extending outwardly from the housing wherein the cutting blade assumes a second configuration different from the first configuration; and

a guide member configured and dimensioned to direct orientation of the cutting blade, operatively connected to the housing and defining a longitudinal axis, the guide member movable from a first orientation wherein the longitudinal axis of the guide member is aligned with a longitudinal axis of the housing to a second orientation wherein the longitudinal axis of the guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing.

2. A surgical instrument according to claim 1, wherein the cutting element is arcuately shaped.

3. A surgical instrument according to claim 1, wherein the cutting element is a composite of a plurality of individual elements joined together.

4. A surgical instrument according to claim 1, wherein the cutting element is a blade having a cutting surface formed on at least one edge of the blade.

5. A surgical instrument according to claim 1, which further comprises a tissue retaining member positioned adjacent the guide member.

6. A surgical instrument according to claim 5, wherein the tissue retaining member is helically shaped such that upon rotation the tissue retaining element spirals through tissue which it contacts.

7. A surgical instrument according to claim 5, wherein the tissue retaining member is fixedly mounted relative to the housing.

8. A surgical instrument according to claim 1, which further comprises an actuator operatively connected to the guide member and movable from a first position to a second position to selectively effect movement of the guide member from the first orientation to the second orientation.

9. A surgical instrument according to claim 8, wherein the actuator is rotatably mounted relative to the housing.

10. A surgical instrument according to claim 1, which further comprises an actuator operatively connected to the cutting element and movable from a first position to a second position to selectively effect movement of the cutting element from the retracted position to the deployed position.

11. A surgical instrument according to claim 10, wherein the actuator is slidably mounted relative to the housing.

12. A surgical instrument for cutting tissue, which comprises:

a housing;

a plurality of cutting elements movable between a retracted position disposed substantially within the housing and a deployed position extending outwardly from the housing; and

a plurality of guide members configured and dimensioned to direct orientation of the plurality of cutting elements, operatively connected to the housing and defining a longitudinal axis, the plurality of guide members being movable from a first orientation wherein the longitudinal axis of at least one of the plurality of guide members is aligned with a longitudinal axis of the housing, to a second orientation wherein the longitudinal axis of the at least one guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing.

13. A surgical instrument according to claim 12, wherein the plurality of guide members are pivotably deployable.

14. A surgical instrument for cutting tissue, which comprises:

a handle portion;

a cutting blade having a variable configuration and being operatively associated with the handle portion and movable between a retracted position wherein the cutting blade assumes a first configuration and a deployed position wherein the cutting blade assumes a second configuration different from the first configuration;

a guide member configured and dimensioned to direct orientation of the cutting blade, operatively associated with the handle portion and defining a longitudinal axis, the guide member movable from a first position wherein the longitudinal axis of the guide member is aligned with a longitudinal axis of the housing to a second position wherein the longitudinal axis of the guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing; and

a tissue retaining member positioned adjacent the guide member and adapted to engage tissue such that the tissue is retained adjacent the guide member.

15. A surgical instrument according to claim 14, wherein the cutting element is arcuately shaped.

16. A surgical instrument according to claim 14, wherein the cutting element is a composite of a plurality of individual elements joined together.

17. A surgical instrument according to claim 14, wherein the cutting element is a blade having a cutting surface formed on at least one edge of the blade.

18. A surgical instrument according to claim 14, wherein the tissue retaining member is helically shaped such that upon rotation the tissue retaining element spirals through tissue which it contacts.

19. A surgical instrument according to claim 18, wherein the tissue retaining member is fixedly mounted relative to the housing.

20. A surgical instrument according to claim 14, which further comprises an actuator operatively connected to the guide member and movable from a first position to a second position to selectively effect movement of the guide member from the first orientation to the second orientation.

21. A surgical instrument according to claim 20, wherein the actuator is rotatably mounted relative to the housing.

22. A surgical instrument according to claim 14, which further comprises an actuator operatively connected to the cutting element and movable from a first position to a second position to selectively effect movement of the cutting element from the retracted position to the deployed position.

23. A surgical instrument according to claim 22, wherein the actuator is slidably mounted relative to the housing.

25. A surgical instrument according to claim 17, wherein the plurality of guide members are pivotably deployable.

24. A surgical instrument which comprises:

a handle portion;

a plurality of cutting elements operatively associated with the handle portion and movable between a retracted position and a deployed position;

a plurality of guide members configured and dimensioned to direct orientation of the plurality of cutting elements, operatively associated with the handle portion and defining a longitudinal axis, at least one of the plurality of guide members movable from a first position wherein the longitudinal axis of the at least one guide member is aligned with a longitudinal axis of the housing to a second position wherein the longitudinal axis of the at least one guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing; and

a tissue retaining member positioned adjacent the plurality of guide members and adapted to engage tissue such that the tissue is retained adjacent the guide member.

26. A method for surgically removing tissue comprising the steps of:

inserting an instrument into an incision formed at the operative site;

deploying a blade guide at an angle relative to a longitudinal axis of the instrument;

deploying a cutting blade from a retracted position wherein the cutting blade assumes a first configuration to an exposed position such that the cutting blade is guided by the blade guide and assumes a second configuration different from the first configuration;

moving the cutting blade through a predetermined path such that a section of tissue is separated from the surrounding tissue; and

removing the cut tissue from the surrounding tissue.

27. A surgical instrument for cutting tissue, which comprises:

a housing;

a cutting element movable between a retracted position disposed substantially within the housing and a deployed position extending outwardly from the housing; and

a guide member defining a passageway therethrough to direct orientation of the cutting element through the passageway, the guide member being operatively connected to the housing and defining a longitudinal axis, the guide member being movable from a first orientation wherein the longitudinal axis of the guide member is aligned with a longitudinal axis of the housing to a second orientation wherein the longitudinal axis of the guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing.

28. A surgical instrument for cutting tissue, which comprises:

a housing;

a flexible cutting blade movable between a retracted position wherein the flexible cutting blade assumes a first configuration disposed substantially within the housing and a deployed position wherein the flexible cutting blade assumes a second configuration extending outwardly from the housing; and

a guide member configured and dimensioned to direct orientation of the cutting edge, operatively connected to the housing and defining a longitudinal axis, the guide member movable from a first orientation wherein the longitudinal axis of the guide member is aligned with a longitudinal axis of the housing to a second orientation wherein the longitudinal axis of the guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing.

29. A surgical instrument for cutting tissue, which comprises:

a housing;

a flexible cutting blade movable between a retracted position disposed substantially within the housing along an arcuate path wherein the cutting blade assumes a second configuration different from the first configuration and a deployed position extending outwardly from the housing, the cutting blade defining a cutting edge formed along at least one side thereof and being rotatable about a central longitudinal axis of the surgical instrument; and

a guide member configured and dimensioned to direct orientation of the cutting element, operatively connected to the housing and defining a longitudinal axis, the guide member movable from a first orientation wherein the longitudinal axis of the guide member is aligned with a longitudinal axis of the housing to a second orientation wherein the longitudinal axis of the guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing.

30. A surgical instrument for cutting tissue, which comprises:

a housing;

a guide member fixedly connected to a distal end of the housing and defining a passageway therethrough and having a longitudinal axis, a portion of the guide member movable from a first orientation wherein the longitudinal axis of the guide member is aligned with a longitudinal axis of the housing to a second orientation wherein the longitudinal axis of the guide member is oriented at a predetermined angle relative to the longitudinal axis of the housing;

an elongated cutting blade slidable through the passageway of the guide member between a retracted position disposed substantially within the housing and a deployed position extending outwardly from the housing; and

wherein the housing includes an actuator actuable to move the elongated cutting blade between the retracted and deployed positions.