Instrument and method for transection of a ligament
First Claim
1. A device for transecting a ligament, comprising:
- a cannula not exceeding twelve inches in length and having proximal and distal ends, each with openings, said cannula defining a lumen and having a lateral opening on one side thereof adjacent to said distal end;
an inflatable member affixed to an external surface of said cannula adjacent to said distal end and opposite said lateral opening, and means for supplying inflation fluid to said inflatable member from said proximal end of said cannula; and
a cutting member on an elongate support equal in length to or longer than said cannula;
said opening at said proximal end being large enough to receive said cutting member and said lumen being large enough to permit passage of said cutting member from said proximal end opening to said lateral opening.
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Accused Products
Abstract
In a procedure for the treatment of carpal tunnel syndrome, the carpal ligament is spread by use of a cutting device passing through the interior of a cannula inserted into the carpal tunnel through an incision in the patient'"'"'s wrist, the cannula containing an inflatable balloon at its distal end to secure the position of the cutting device against the carpal ligament, and the cutting device comprising a blade whose position is remotely controlled from the proximal end of the device. Other features of the procedure are the use of a blunt-tipped hypodermic needle and exchange wire to establish a path to the site under the carpal ligament, an endoscope or other visualization device to be inserted through the cannula with the cutting device, and a removable sheath over the cannula to contain the inflatable balloon until inflation is desired.
125 Citations
31 Claims
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1. A device for transecting a ligament, comprising:
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a cannula not exceeding twelve inches in length and having proximal and distal ends, each with openings, said cannula defining a lumen and having a lateral opening on one side thereof adjacent to said distal end; an inflatable member affixed to an external surface of said cannula adjacent to said distal end and opposite said lateral opening, and means for supplying inflation fluid to said inflatable member from said proximal end of said cannula; and a cutting member on an elongate support equal in length to or longer than said cannula; said opening at said proximal end being large enough to receive said cutting member and said lumen being large enough to permit passage of said cutting member from said proximal end opening to said lateral opening. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A cutting device for remote actuation through a cannula, said cutting device comprising:
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first and second elongate members, each having proximal and distal ends and each being longitudinally moveable relative to the other; a blade pivotally mounted to said first elongate member at said distal end thereof, and means on said second elongate member for engaging said blade and for causing said blade to pivot when one of said elongate members is moved longitudinally relative to the other; wherein said blade has a linear cutting edge, and said blade is pivotally mounted to said first elongate member to pivot between a retracted position in which said linear cutting edge is substantially parallel to said first elongate member and an exposed position in which said linear cutting edge is transverse to said first elongate member. - View Dependent Claims (9, 10, 11, 12, 13, 14)
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15. A device for transecting a ligament, comprising:
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a cannula having proximal and distal ends, with an opening at said proximal end, said cannula defining a lumen and having a lateral opening on one side thereof adjacent to said distal end; an inflatable member affixed to an external surface of said cannula adjacent to said distal end and opposite said lateral opening, and means for supplying inflation fluid to said inflatable member from said proximal end of said cannula; and a cutting member comprising (a) first and second elongate members, each having proximal and distal ends and each being longitudinally movable relative to the other;
(b) a blade pivotally mounted to said first elongate member at said distal end thereof; and
(c) means on said second elongate member for engaging said blade and for causing, by the longitudinal movement of one of said elongate members relative to the other, said blade to pivot between a retracted position in which said blade is fully retained inside said cannula lumen and an exposed position in which said blade protrudes through said lateral opening of said cannula;said opening at said proximal end of said cannula being large enough to receive said cutting member and said cannula lumen being large enough to permit passage of said cutting member from said proximal end opening to said lateral opening. - View Dependent Claims (16, 17, 18, 19)
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20. A method for transecting a ligament in a patient, said method comprising:
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(a) inserting a cannula through an incision in said patient located laterally relative to said ligament, said cannula having a lateral opening on one side thereof and an inflatable member affixed to an external surface thereof on a side opposite that of said lateral opening, and advancing said cannula to a position adjacent and transverse to said ligament, whereby said lateral opening resides adjacent to said ligament; (b) inserting a cutting member into said cannula, said cutting member having proximal and distal ends and containing a cutting edge at said distal end and movable from said proximal end between a retracted position and an operating position, and advancing said cutting member through said cannula to a position whereby said cutting edge is adjacent to said lateral opening; (c) inflating said inflatable member to urge said lateral opening against said ligament; (d) moving said cutting edge to said operating position whereby said cutting edge engages said ligament; and (e) traversing said ligament with said cutting edge. - View Dependent Claims (21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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Specification