Apparatus and method for minimally invasive surgery using rotational cutting tool

• US 6,428,539 B1
• Filed: 03/09/2000
• Issued: 08/06/2002
• Est. Priority Date: 03/09/2000
• Status: Expired due to Term

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: Origin Medsystems Inc. (Eli Lilly and Company)
• Inventors: Baxter, Jeffrey W., Davis, John
• Primary Examiner(s): Cohen, Lee
• Assistant Examiner(s): JOHNSON III, HENRY M
• Application Number:
  US09/522,254
• Time in Patent Office: 880 Days
• Field of Search: 606/27-50, 606/167-180
• US Class Current: 606/49
• CPC Class Codes: A61B 17/00008 Vein tendon strippers tube strippers A61M1/83
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• 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 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2017/320741 for stripping the intima or the internal plaque from a blood vessel, e.g. for endarterectomy
• CPC Class Codes: A61B 2018/00202 rotating
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter

Abstract

An apparatus and method for minimally invasive surgery using a cutting tool with rotational cutting edges. The surgical instrument includes a tube having a distal end and a cutting edge at the distal end. A handle is attached to the proximal end of the tube. Within the tube is a shaft having a longitudinally extending blade at its distal end that is adjacent to the distal end of the tube. The blade is revolvable about the longitudinal axis of the instrument to provide rotational cutting action. One or both of the blade and the cutting edge on the tube can be electrically energized to provide for electrocauterization of the body tissue being cut.

Claims

1. A surgical instrument comprising:

a tube having a distal end and a proximal end, said distal end including a cutting edge; and

a shaft within said tube, said shaft having a distal end and a proximal end, said distal end of said shaft including a blade, one of said shaft and said tube being rotatable with respect to the other such that said blade cooperates with said cutting edge;

wherein said tube has a first axis and said shaft has a second axis displaced from said first axis.

2. A surgical instrument comprising:

a tube having a distal end and a proximal end, said distal end including a cutting edge; and

a shaft within said tube, said shaft having a distal end and a proximal end, said distal end of said shaft including a blade, one of said shaft and said tube being rotatable with respect to the other such that said blade cooperates with said cutting edge;

wherein both said cutting edge and said blade are adapted to be electrically energized.

3. A surgical instrument comprising:

a tube having a distal end and a proximal end, said distal end including a cutting edge; and

a shaft within said tube, said shaft having a distal end and a proximal end, said distal end of said shaft including a blade, one of said shaft and said tube being rotatable with respect to the other such that said blade cooperates with said cutting edge;

further comprising an outer electrode on a surface of said tube, said outer electrode being adjacent said cutting edge, and an inner electrode on a surface of said blade, wherein said blade and said cutting edge mechanically cooperate to cut body tissue, and said inner electrode cooperates with said outer electrode to provide electrocautery of the body tissue being cut.

4. A surgical instrument comprising:

a tube having a distal end and a proximal end, said distal end including a cutting edge; and

a shaft within said tube, said shaft having a distal end and a proximal end, said distal end of said shaft including a blade, one of said shaft and said tube being rotatable with respect to the other such that said blade cooperates with said cutting edge;

wherein said shaft is fixedly attached to a handle and said tube is rotatable relative to said shaft.

5. A surgical instrument comprising:

a tube having a distal end and a proximal end, said distal end including a cutting edge; and

a shaft within said tube, said shaft having a distal end and a proximal end, said distal end of said shaft including a blade, one of said shaft and said tube being rotatable with respect to the other such that said blade cooperates with said cutting edge;

wherein said shaft and said tube are both rotatable.

6. A surgical instrument comprising:

a tube having a distal end and a proximal end, said distal end including an outer cutting edge; and

a tubular shaft within said tube and coaxial with said tube, said shaft having a distal end, a proximal end, and a blade extending longitudinally from said distal end, said blade including an inner cutting edge, wherein said tube and said tubular shaft are rotatable about a common axis such that said inner cutting edge is operatively associated with said outer cutting edge.

7. The instrument of claim 6 wherein at least one of said blade and said outer cutting edge is adapted to be electrically energized.

8. The instrument of claim 6 further comprising an outer electrode on a surface of said tube, said outer electrode being adjacent said outer cutting edge, and an inner electrode on a surface of said blade, wherein said blade and said outer cutting edge mechanically cooperate to cut body tissue, and said inner electrode cooperates with said outer electrode to provide electrocautery of the body tissue being cut.

9. The instrument of claim 6 wherein one of said outer cutting edge and said inner cutting edge is serrated.

10. The instrument of claim 6 wherein said distal end of said tube includes a first outer cutting edge and a second outer cutting edge and said blade includes a first inner cutting edge and a second inner cutting edge.

11. The instrument of claim 10 wherein at least one of said first outer cutting edge, said second outer cutting edge, said first inner cutting edge, and said second inner cutting edge is serrated.

12. The instrument of claim 6 further comprising a handle operatively associated with said proximal ends of said tube and said tubular shaft.

13. The instrument of claim 12 wherein said handle includes a tube controller coupled to said tube and a shaft controller coupled to said shaft.

15. The instrument of claim 6 wherein said shaft is tubular and defines an inner lumen.

16. The instrument of claim 15 wherein said inner lumen is configured to receive an imaging device inserted therein.

17. The instrument of claim 15 wherein said inner lumen is configured to receive a separate surgical instrument inserted therein.

18. A surgical instrument comprising:

a handle;

a tube extending from and coupled to said handle, said tube having a distal end and a cutting edge at said distal end, said tube having a proximal end associated with said handle;

a tubular shaft defining a lumen coaxial with said tube, said shaft rotatable disposed within said tube, said shaft having a proximal end adjacent said handle and a distal end adjacent said distal end of said tube, said shaft having a cutting edge at its distal end, wherein one of said cutting edge on said shaft and said cutting edge on said tube is adapted to be electrically energized, wherein said handle defines an opening in communication with said lumen of said tubular shaft, wherein said opening and said lumen provide access through the instrument to said distal end of said tubular shaft; and

an auxiliary instrument inserted through said opening.

14. The instrument of claim 18 wherein said handle includes an elongated grip, said tube controller includes a first ring rotatable mounted on said grip, and said shaft controller includes a second ring rotatable mounted on said grip.

19. A surgical instrument comprising:

a handle;

a tube extending from and coupled to said handle, said tube having a distal end and a cutting edge at said distal end, said tube having a proximal end associated with said handle; and

a tubular shaft defining a lumen coaxial with said tube, said shaft rotatable disposed within said tube, said shaft having a proximal end adjacent said handle and a distal end adjacent said distal end of said tube, said shaft having a cutting edge at its distal end, wherein one of said cutting edge on said shaft and said cutting edge on said tube is adapted to be electrically energized;

wherein said auxiliary instrument is selected from the group consisting of a suction cannula, an irrigation cannula, an imaging device, and a sensor.

20. A surgical instrument comprising:

a handle;

a tube extending from and coupled to said handle, said tube having a distal end and a cutting edge at said distal end, said tube having a proximal end associated with said handle; and

a tubular shaft defining a lumen coaxial with said tube, said shaft rotatable disposed within said tube, said shaft having a proximal end adjacent said handle and a distal end adjacent said distal end of said tube, said shaft having a cutting edge at its distal end, wherein one of said cutting edge on said shaft and said cutting edge on said tube is adapted to be electrically energized;

wherein said cutting edge on said tube extends at an angle away from said tube.

21. A surgical instrument comprising:

a handle;

a tube extending from and coupled to said handle, said tube having a distal end and a cutting edge at said distal end, said tube having a proximal end associated with said handle; and

a tubular shaft defining a lumen coaxial with said tube, said shaft rotatably disposed within said tube, said shaft having a proximal end adjacent said handle and a distal end adjacent said distal end of said tube, said shaft having a cutting edge at its distal end, wherein one of said cutting edge on said shaft and said cutting edge on said tube is adapted to be electrically energized;

wherein said cutting edge on said shaft extends at an angle away from said tube.

22. A surgical instrument comprising:

a handle;

a tube extending from and coupled to said handle, said tube having a distal end and a cutting edge at said distal end, said tube having a proximal end associated with said handle; and

a tubular shaft defining a lumen coaxial with said tube, said shaft rotatably disposed within said tube, said shaft having a proximal end adjacent said handle and a distal end adjacent said distal end of said tube, said shaft having a cutting edge at its distal end, wherein one of said cutting edge on said shaft and said cutting edge on said tube is adapted to be electrically energized;

wherein said distal end of said tube includes a first scoop and said distal end of said shaft includes a second scoop such that said first and second scoops are operatively associated to collect a biopsy sample when said shaft is rotated within said tube.

23. A surgical instrument comprising:

a handle;

a tube extending from and coupled to said handle, said tube having a distal end and a cutting edge at said distal end, said tube having a proximal end associated with said handle; and

a tubular shaft defining a lumen coaxial with said tube, said shaft rotatably disposed within said tube, said shaft having a proximal end adjacent said handle and a distal end adjacent said distal end of said tube, said shaft having a cutting edge at its distal end, wherein one of said cutting edge on said shaft and said cutting edge on said tube is adapted to be electrically energized;

wherein said tube and said shaft are telescoping.

24. A surgical instrument comprising:

a handle;

a tube having a distal end and an outer blade extending from said distal end, said tube having a proximal end associated with said handle and said tube having a first longitudinal axis; and

a shaft disposed within said tube, said shaft having a distal end adjacent said distal end of said tube and said shaft having a second longitudinal axis displaced from said first longitudinal axis and said shaft having an inner blade extending from said distal end, said shaft having a proximal end extending into said handle, wherein said inner blade and said outer blade are adapted to be electrically energized.

25. The instrument of claim 24 wherein said tube is fixedly attached to said handle and said shaft is revolvable about said first longitudinal axis relative to said tube.

26. A surgical instrument comprising:

a handle;

a tube having a distal end and an outer blade extending from said distal end, said tube having a proximal end associated with said handle; and

a shaft disposed within said tube, said shaft having a distal end adjacent said distal end of said tube, said shaft having an inner blade extending from said distal end, said shaft having a proximal end extending into said handle, wherein said inner blade and said outer blade are adapted to be electrically energized;

wherein said tube has a first longitudinal axis and said shaft has a second longitudinal axis displaced from said first longitudinal axis;

wherein said shaft is fixedly attached to said handle and said tube is rotatable about said first longitudinal axis relative to said shaft.

27. A surgical instrument comprising:

a handle;

a tube having a distal end and an outer blade extending from said distal end, said tube having a proximal end associated with said handle; and

a shaft disposed within said tube, said shaft having a distal end adjacent said distal end of said tube, said shaft having an inner blade extending from said distal end, said shaft having a proximal end extending into said handle, wherein said inner blade and said outer blade are adapted to be electrically energized;

wherein said shaft is revolvable about said first longitudinal axis relative to said tube, and said tube is rotatable about said first longitudinal axis relative to said shaft.