Tissue remover and method

• US 6,669,685 B1
• Filed: 11/15/2000
• Issued: 12/30/2003
• Est. Priority Date: 11/06/1997
• Status: Expired due to Term

• Current Assignee: Biolase Incorporated
• Original Assignee: Biolase Technology Inc
• Inventors: Kimmel, Andrew I, Rizoiu, Ioana M.
• Primary Examiner(s): Shay, David M.
• Application Number:
  US09/714,479
• Time in Patent Office: 1,140 Days
• Field of Search: 606/3, 606/7, 606/10-18, 606/131, 606/167, 606/170, 604/20, 604/22, 604/27, 604/35, 604/48, 604/50, 604/506-508, 604/514-517
• US Class Current: 606/10
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2218/008 for smoke evacuation
• CPC Class Codes: B23K 26/0096 Portable laser equipment, e.g. hand-held laser apparatus surgical laser instruments A61B18/20, Dental Lasers A61C1/0046, Hand-held laser dental apparatus for curing resins A61C19/004
• CPC Class Codes: B23K 26/146 the fluid stream containing a liquid

Abstract

An electromagnetically induced cutting mechanism provides accurate cutting operations on soft tissues. The electromagnetically induced cutter is adapted to interact with atomized fluid particles. A tissue remover comprises an aspiration cannula housing a fluid and energy guide for conducting electromagnetically induced cutting forces to the site within a patient'"'"'s body for aspiration of soft tissue. The cannula is provided with a cannula distal end. The proximal end of the cannula is provided with fluid flow connection to an aspiration source. Separated soft tissue and fluid are aspirated through the cannula distal end and the cannula by an aspiration source at the proximal end of the cannula.

Claims

1. A tissue remover comprising:

an aspiration cannula having a cannula proximal end and a cannula distal end, the cannula being provided with a cannula lumen in communication with the cannula distal end, the cannula distal end being adapted to receive soft or hard tissue therein and into the cannula lumen;

a fluid and energy guide disposed within the cannula and longitudinally extending within the cannula lumen, the fluid and energy guide transporting air and fluid to a distal end of the fluid and energy guide and being adapted to generate atomized fluid particles in an interaction zone located in close proximity to the distal end of the fluid and energy guide near the cannula distal end, the fluid and energy guide further providing electromagnetic energy from an energy source to an electromagnetic energy transmitting means operatively mounted within the fluid and energy guide, the electromagnetic energy having a wavelength which is substantially absorbed by a portion of atomized fluid particles in the interaction zone, the absorption of the electromagnetic energy by the portion of atomized fluid particles causing the portion of atomized fluid particles to expand and impart disruptive cutting forces onto soft or hard tissue in close proximity with the cannula distal end; and

a source of aspiration connected to a proximal end of the cannula, the source of aspiration being configured to aspirate, during the transporting of the air and the fluid and during the transmitting of the electromagnetic energy, air and fluid from the fluid and energy guide, and soft or hard tissue within the cannula, through the cannula distal end and the cannula.

2. The tissue remover according to claim 1, wherein the electromagnetic energy source comprises an erbium, chromium, yttrium, scandium, gallium garnet (Er, Cr:

YSGG) solid state laser.

3. The tissue remover according to claim 1, wherein the electromagnetic energy source comprises a CO₂ laser.

4. The tissue remover according to claim 1, wherein the aspiration cannula is formed of a medical grade plastic.

5. The tissue remover according to claim 1, wherein the aspiration cannula is formed of a stainless steel.

6. The tissue remover according to claim 1, wherein the electromagnetic energy transmitting means is a fiber optic delivery system.

7. The tissue remover according to claim 1, wherein the fluid comprises water.

8. The tissue remover according to claim 1, wherein the fluid comprises an anesthetic.

9. The tissue remover according to claim 1, wherein the fluid comprises a saline solution.

10. The tissue remover according to claim 1, wherein the fluid comprises epinephrine.

11. The tissue remover according to claim 1, wherein the energy source comprises an ER:

YAG laser.

12. The tissue remover according to claim 1, wherein the fluid comprises epinephrine and an anesthetic.

25. The method of claim 1, wherein the tissue comprises cartilage or bone.

26. The method of claim 1, wherein the fluid comprises epinephrine and an anesthetic.

13. A tissue remover comprising:

a tissue remover cannula having a cannula proximal end and a cannula distal end, the cannula being provided with a cannula lumen in communication with the cannula distal end, the cannula distal end being adapted to receive soft or hard tissue therein and into the cannula lumen;

an imager disposed within the cannula lumen, the imager being adapted to provide an image to a user of an area in proximity to the cannula distal end;

a fluid and energy guide disposed within the cannula, the fluid and energy guide transporting air and fluid to a distal end of the fluid and energy guide and being adapted to generate fluid particles in an interaction zone located in close proximity to the distal end of the fluid and energy guide near the cannula distal end, the fluid and energy guide further providing electromagnetic energy from an energy source to an electromagnetic energy transmitter within the fluid and energy guide, the electromagnetic energy having a wavelength which is substantially absorbed by a portion of fluid particles in the interaction zone, the absorption of the electromagnetic energy by the portion of fluid particles causing the portion of fluid particles to expand and impart disruptive cutting forces onto soft or hard tissue in close proximity with the cannula distal end; and

,

a source of aspiration connected to a proximal end of the cannula, the source of aspiration being configured to aspirate, during the transporting of the air and the fluid and during the providing of the electromagnetic energy, air and fluid from the fluid and energy guide, and tissue debris within the cannula, through the cannula distal end and the cannula.

14. The method as set forth in claim 13, wherein the energy source comprises an Er, Cr:

YSGG laser.

15. The method as set forth in claim 13, wherein the energy source comprises an infrared laser and the imager comprises an infrared imager.

16. The method as set forth in claim 15, wherein the imager maps temperature differences of tissue in close proximity with the cannula distal end by detecting electromagnetic radiation from tissue that is at different temperatures from its surroundings.

17. An in vivo surgical method of aspirating tissue from a patient comprising:

inserting an aspiration cannula through the patient'"'"'s epidermis, so that a distal end of the cannula is positioned in close proximity to an area of tissue, the cannula being provided with a cannula lumen in communication with the cannula distal end;

transmitting air and fluid through a fluid and energy guide, the fluid and energy guide longitudinally extending within the cannula lumen;

generating atomized fluid particles in an interaction zone located in close proximity to the cannula distal end, using the air and fluid transmitted through the fluid and energy guide;

providing electromagnetic energy from an energy source to an electromagnetic energy transmitting means operatively mounted within the fluid and energy guide;

transmitting the electromagnetic energy from an output end of the energy transmitting means into the interaction zone, the electromagnetic energy having a wavelength which is substantially absorbed by a portion of atomized fluid particles in the interaction zone, the absorption of the electromagnetic energy by the portion of atomized fluid particles causing the portion of atomized fluid particles to expand and impart disruptive cutting forces onto the portion of the area of tissue in close proximity to the cannula distal end; and

providing a source of aspiration at a proximal end of the cannula, wherein the source of aspiration is configured to aspirate, during the imparting of disruptive forces, air and water from the fluid and energy guide, and tissue debris within the cannula, through the cannula distal end and the cannula.

18. The method of claim 17, wherein the tissue comprises joint tissue.

19. The method of claim 17, wherein the tissue is located within the brain, the eye, the trachea or the abdomen.

20. The method of claim 17, wherein the cannula distal end is generally rounded or bullet-shaped to facilitate insertion into the patient'"'"'s tissue with a minimum of localized tissue trauma.

21. The method of claim 17, wherein the fluid comprises water.

22. The method of claim 17, wherein the fluid comprises an anesthetic.

23. The method of claim 17, wherein the fluid comprises a saline solution.

24. The method of claim 17, wherein the fluid comprises epinephrine.

27. The method of claim 17, wherein:

the generating of atomized fluid particles comprises generating atomized water particles;

the providing of electromagnetic energy from an energy source comprises providing laser energy from an erbium, chromium, yttrium, scandium, gallium garnet (Er, Cr;

YSGG) solid state laser; and

the absorption of the electromagnetic energy by the portion of atomized water particles causing the portion of atomized water particles to expand and impart disruptive cutting forces onto the portion of the area of tissue in close proximity to the cannula distal end.

28. The method of claim 17, wherein:

the generating of atomized fluid particles comprises generating atomized water particles;

the providing of electromagnetic energy from an energy source comprises providing laser energy from a CO2 laser; and

the absorption of the electromagnetic energy by the portion of atomized water particles causing the portion of atomized water particles to expand and impart disruptive cutting forces onto the portion of the area of tissue in close proximity to the cannula distal end.

29. The method of claim 17, wherein:

the generating of atomized fluid particles comprises generating atomized water particles;

the providing of electromagnetic energy from an energy source comprises providing laser energy from an Er;

YAG laser; and

the absorption of the electromagnetic energy by the portion of atomized water particles causing the portion of atomized water particles to expand and impart disruptive cutting forces onto the portion of the area of tissue in close proximity to the cannula distal end.