Electrosurgical cutter

• US 7,150,747 B1
• Filed: 01/22/2003
• Issued: 12/19/2006
• Est. Priority Date: 01/22/2003
• Status: Active Grant

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: McDonald, Christopher, Lopes, Albert R. Jr., Drucker, Karen, Sjostrom, Douglas D., Brodsky, Michael A.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US10/348,343
• Time in Patent Office: 1,427 Days
• Field of Search: 606/41, 606 45- 52, 606/170, 606/180, 606/181, 604/21, 604/22, 604/35
• US Class Current: 606/45
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 2018/00208 actively driven, e.g. by a motor
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter

Abstract

One surgical device includes a first member and a second member defining a lumen for receiving the first member. The first member is configured to be movable relative to the second member to cut tissue. An electrical connector is physically and electrically coupled to the second member, to electrically couple the second member to a source of electricity. A tension device holds a distal region of the first member in electrical contact with a distal region of the second member. The first member includes a blade used both to cut tissue mechanically, and to coagulate cut tissue. The blade is electrically conductive and serves as an active electrode in a bipolar arrangement with a return electrode. Electrical energy is transferred to the blade through a point contact at a distal tip of the first and second members.

Claims

1. A surgical device comprising:

a first member that defines an inner lumen operable as an aspiration lumen;

a second member defining a lumen for receiving the first member, the first member and second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity; and

a tension device for holding a distal region of the first member in electrical contact with a distal region of the second member.

2. The surgical device of claim 1 wherein the electrical connector is self-centering on the second member.

3. The surgical device of claim 1 wherein the second member comprises a tube and the electrical connector comprises a three-point connector that is self-centering on the tube.

4. The surgical device of claim 1 further comprising a third member physically coupled to the second member and electrically isolated from the distal region of the first member.

5. The surgical device of claim 4 wherein:

the surgical device further comprises a first electrode in electrical contact with the distal region of the first member,

the third member comprises a second electrode, and

the surgical device is operable as a bipolar electrosurgical device using the first electrode and the second electrode.

6. The surgical device of claim 5 wherein:

the first member comprises a first tube,

the second member comprises a second tube, the second tube being cylindrical, and

the third member comprises a third tube disposed about the second tube.

7. The surgical device of claim 5 wherein an exposed surface area of the second electrode is at least approximately five times larger than an exposed surface area of the first electrode.

8. The surgical device of claim 1 further comprising an electrode in electrical contact with the distal region of the first member, wherein the surgical device is operable as a monopolar electrosurgical device using the electrode.

9. The surgical device of claim 8 wherein the electrode is part of the first member.

10. The surgical device of claim 1 wherein the tension device holds a tip of the first member in electrical contact with a tip of the second member.

11. The surgical device of claim 1 wherein the first member defines a longitudinal axis and the tension device applies tension along the longitudinal axis of the first member.

12. The surgical device of claim 1 wherein the tension device comprises a spring.

13. The surgical device of claim 1 further comprising a lock physically coupled to the second member for coupling the second member to the tension device.

14. The surgical device of claim 1 further comprising a drive unit coupled to the first member for moving the first member relative to the second member, wherein the second member is fixed with respect to the drive unit.

15. The surgical device of claim 1 wherein the first member comprises an electrically conductive cutting surface configured to cut tissue mechanically and to perform electrosurgery.

16. The surgical device of claim 15 wherein the cutting surface comprises a blade.

17. The surgical device of claim 15 wherein the cutting surface comprises a burr.

18. The surgical device of claim 15 wherein the electrosurgery comprises coagulation.

19. The surgical device of claim 15 wherein the second member comprises a cutting surface configured to cut tissue mechanically in cooperation with the electrically conductive cutting surface of the first member.

20. The surgical device of claim 19 wherein a portion of the cutting surface of the second member is electrically conductive and is configured to perform electrosurgery along with the cutting surface of the first member.

21. The surgical device of claim 19 wherein the cutting surfaces of the first member and the second member are configured to be moved past each other and to cut tissue mechanically that is disposed between the two cutting surfaces as the two cutting surfaces are moved past each other.

22. The surgical device of claim 15 wherein the second member comprises an electrically insulating cutting surface configured to cut tissue mechanically in cooperation with the electrically conductive cutting surface of the first member.

23. The surgical device of claim 1 wherein the first member is configured to be rotated relative to the second member to cut tissue.

24. The surgical device of claim 23 wherein:

the first member comprises a first tube, and

the second member comprises a second tube, the second tube being cylindrical.

25. The surgical device of claim 1 wherein the first member is substantially electrically insulating, and the first member comprises an electrically conductive material at the distal region of the first member.

26. The surgical device of claim 25 wherein the second member is substantially electrically insulating, and includes an electrically conductive material at the distal region of the second member.

27. The surgical device of claim 1 further comprising:

a drive unit coupled to the first member to move the first member relative to the second member, wherein the second member is fixed with respect to the drive unit;

a first electrode in electrical contact with the distal region of the first member, the first electrode including a cutting surface configured to cut tissue mechanically and to perform electrosurgery; and

a second electrode physically coupled to the second member and electrically isolated from the distal region of the first member,

wherein the distal region of the first member comprises a tip of the first member and the distal region of the second member comprises a tip of the second member.

28. A method of performing surgery, the method comprising:

inserting a surgical device into a body, the surgical device including a first member and a second member, the second member defining a lumen for receiving the first member,

moving the first member and second member relative to each other to cut tissue;

holding a distal region of the first member in electrical contact with a distal region of the second member; and

providing electrical power to the first member through the second member,

wherein;

inserting the surgical device comprises inserting a surgical device having an inner cutting surface on the first member and an outer cutting surface on the second member;

moving the first member and the second member relative to each other comprises cutting tissue in the body using the inner cutting surface and the outer cutting surface; and

providing electrical power further includes performing electrosurgery on the cut tissue using the inner cutting surface.

29. The method of claim 28 further comprising maintaining a distal tip of the first member in electrical connection with a distal tip of the second member.

30. The method of claim 28 wherein moving the first member and second member relative to each other comprises rotating the first member relative to the second member, such rotating causing the inner cutting surface to pass by the outer cutting surface and causing tissue disposed between the two cutting surfaces to be cut mechanically.

31. The method of claim 28 further comprising providing a conductive environment in the body, and wherein inserting the surgical device into the body includes inserting the inner cutting surface into the conductive environment.

32. The method of claim 28 wherein performing electrosurgery comprises performing bipolar electrosurgery using the inner cutting surface as an electrode.

33. The method of claim 32 wherein inserting the surgical device comprises inserting a surgical device that includes a third member coupled to the second member and including a return electrode.

34. A surgical device comprising:

a first member that defines an inner lumen operable as an aspiration lumen;

a second member defining a lumen for receiving the first member, the first member and the second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity; and

means for holding a distal region of the first member in electrical contact with a distal region of the second member.

35. A surgical device comprising:

a first member;

a second member defining a lumen for receiving the first member, the first member and second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity, wherein the second member comprises a tube and the electrical connector comprises a three-point connector that is self-centering on the tube; and

a tension device for holding a distal region of the first member in electrical contact with a distal region of the second member.

36. A surgical device comprising:

a first member;

a second member defining a lumen for receiving the first member, the first member and second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity;

a tension device for holding a distal region of the first member in electrical contact with a distal region of the second member; and

a third member physically coupled to the second member and electrically isolated from the distal region of the first member,

wherein;

the surgical device further comprises a first electrode in electrical contact with the distal region of the first member,

the third member comprises a second electrode, and

the surgical device is operable as a bipolar electrosurgical device using the first electrode and the second electrode.

37. The surgical device of claim 36 wherein:

the first member comprises a first tube,

the second member comprises a second tube, the second tube being cylindrical, and

the third member comprises a third tube disposed about the second tube.

38. The surgical device of claim 36 wherein an exposed surface area of the second electrode is at least approximately five times larger than an exposed surface area of the first electrode.

39. A surgical device comprising:

a first member;

a second member defining a lumen for receiving the first member, the first member and second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity; and

a tension device for holding a distal region of the first member in electrical contact with a distal region of the second member,

wherein the first member comprises an electrically conductive cutting surface configured to cut tissue mechanically and to perform electrosurgery and the cutting surface comprises a burr.

40. A surgical device comprising:

a first member;

a second member defining a lumen for receiving the first member, the first member and second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity; and

a tension device for holding a distal region of the first member in electrical contact with a distal region of the second member,

wherein the first member comprises an electrically conductive cutting surface configured to cut tissue mechanically and to perform electrosurgery, and the second member comprises a cutting surface configured to cut tissue mechanically in cooperation with the electrically conductive cutting surface of the first member.

41. The surgical device of claim 40 wherein a portion of the cutting surface of the second member is electrically conductive and is configured to perform electrosurgery along with the cutting surface of the first member.

42. The surgical device of claim 40 wherein the cutting surfaces of the first member and the second member are configured to be moved past each other and to cut tissue mechanically that is disposed between the two cutting surfaces as the two cutting surfaces are moved past each other.

43. A surgical device comprising:

a first member;

a second member defining a lumen for receiving the first member, the first member and second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity; and

a tension device for holding a distal region of the first member in electrical contact with a distal region of the second member,

wherein the first member comprises an electrically conductive cutting surface configured to cut tissue mechanically and to perform electrosurgery, and the second member comprises an electrically insulating cutting surface configured to cut tissue mechanically in cooperation with the electrically conductive cutting surface of the first member.

44. A surgical device comprising:

a first member;

a second member defining a lumen for receiving the first member, the first member and second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity; and

a tension device for holding a distal region of the first member in electrical contact with a distal region of the second member,

wherein;

the first member is configured to be rotated relative to the second member to cut tissue,

the first member comprises a first tube, and

the second member comprises a second tube, the second tube being cylindrical.

45. A surgical device comprising:

a first member;

a second member defining a lumen for receiving the first member, the first member and second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity; and

a tension device for holding a distal region of the first member in electrical contact with a distal region of the second member,

wherein the first member is substantially electrically insulating, and the first member comprises an electrically conductive material at the distal region of the first member.

46. The surgical device of claim 45 wherein the second member is substantially electrically insulating, and includes an electrically conductive material at the distal region of the second member.

47. A surgical device comprising:

a first member;

a second member defining a lumen for receiving the first member, the first member and second member being configured to be movable with respect to each other to cut tissue;

an electrical connector physically and electrically coupled to the second member for electrically coupling the second member to a source of electricity;

a tension device for holding a distal region of the first member in electrical contact with a distal region of the second member;

a drive unit coupled to the first member to move the first member relative to the second member, wherein the second member is fixed with respect to the drive unit;

a first electrode in electrical contact with the distal region of the first member, the first electrode including a cutting surface configured to cut tissue mechanically and to perform electrosurgery; and

a second electrode physically coupled to the second member and electrically isolated from the distal region of the first member,

wherein the distal region of the first member comprises a tip of the first member and the distal region of the second member comprises a tip of the second member.