Surgical instrument and method

• US 7,854,736 B2
• Filed: 01/15/2010
• Issued: 12/21/2010
• Est. Priority Date: 03/04/2005
• Status: Active Grant

• Current Assignee: Gyrus ENT LLC (Olympus Corporation)
• Original Assignee: Gyrus ENT LLC (Olympus Corporation)
• Inventors: Ryan, Phillip Andrew
• Primary Examiner(s): Dvorak; Linda C
• Assistant Examiner(s): SCOTT, AMANDA L
• Application Number:
  US12/656,096
• Publication Number:
  US 20100121321A1
• Time in Patent Office: 340 Days
• Field of Search: 606 41- 45, 606/50, 606/167, 606/169, 606/170, 606/171, 606/176, 606/178, 606/179
• US Class Current: 606/50
• 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 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• 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 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00208 actively driven, e.g. by a motor
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 2218/002 Irrigation

Abstract

A surgical instrument comprises a hollow tube (18) having a cutting window (16) at the distal end portion. An inner tube (15) is disposed within the tube (18) and is mounted for rotation about its longitudinal axis. A cutting tool (17) is located at the distal end of the tube (15), and is positioned adjacent to the cutting window (16). An outer tube (14) is provided over the tube (18). A motor (5) is provided for rotating the inner tube (15), and saline is fed to the cutting window (16) via a passageway (25) between the tubes (15) and (18). The inner tube (15) has a central lumen (24) through which tissue cut by the cutting tool (17) is removed under the action of a source of suction (12). The outer surface of the tube 18 is covered with an electrically insulating layer (22) and coagulating RF signals are supplied between the tube (18) and the outer tube (14) so as to coagulate tissue at the cutting window (16). Additional apertures (40, 42; 43, 45) in the outer tube (14) and the insulating layer (22) are aligned such that a portion of the hollow tube (18) is exposed other than in the area of the cutting window (16).

Claims

1. A blade assembly for a surgical instrument usable with an electrosurgical generator, the blade assembly being usable to cut tissue and comprising:

a) an electrically conductive, hollow intermediate tube having a distal end, a tip at the distal end, a central passageway and a cutting window at the distal end;

b) a hollow inner tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen, the inner tube defining a distal end;

c) a cutting tool disposed at the distal end of the inner tube that is accessible to the tissue through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge;

d) an electrically conductive outer tube disposed over the intermediate hollow tube, the outer tube having a distal end and an opening at the distal end of the outer tube, the opening being radially aligned with the cutting window of the intermediate tube, the outer tube also defining a slot extending across a tip of the distal end;

e) an electrically insulating layer disposed between the intermediate and outer tubes, the insulating layer defining a distal end and a slot extending across a tip of the distal end; and

f) first and second contacts associated with the outer and intermediate tubes respectively, which connect the outer and intermediate tubes to respective poles of the electrosurgical generator;

wherein the rotation of the cutting tool cuts tissue adjacent to the cutting window of the intermediate tube, while the intermediate and outer tubes form electrodes of a bipolar electrosurgical instrument capable of coagulating the tissue adjacent to the cutting window of the intermediate tube, the slots of the outer tube and the insulating layer being aligned such that the distal tip of the intermediate tube is exposed through the slots of the outer tube and the insulating layer to the tissue and is capable of coagulating tissue at the distal tip of the intermediate tube.

2. A blade assembly according to claim 1 wherein the electrically insulating layer is an insulating material on the outer surface of the intermediate tube.

3. A blade assembly according to claim 1 wherein the slots in the outer tube and the insulating layer extend from the cutting window of the intermediate tube.

4. A blade assembly according to claim 3 wherein the slot in the outer tube extends from the cutting window of the intermediate tube along a distal tip of the blade assembly to the reverse of the outer tube opposite the cutting window of the outer tube.

5. A blade assembly according to claim 1 wherein the slots in the outer tube and the insulating layer comprise a discrete portion on the distal tip of the blade assembly.

6. A method of surgically removing tissue from a surgical site on or in the body of a patient, the method comprising the steps of

i) introducing to the surgical site a surgical instrument including

a) an electrically conductive intermediate hollow tube having a central passageway and a cutting window at a distal end thereof;

b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen;

c) a cutting tool disposed at a distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge;

d) an electrically conductive outer tube disposed over the intermediate hollow tube and defining a first opening at a distal end of the outer tube that is radially aligned with the cutting window of the intermediate tube, and a first slot that extends from the cutting window across a distal tip of the outer tube; and

e) an electrically insulating layer disposed between the intermediate and outer tubes, the electrically insulating layer defining a second slot in alignment with the first slot in the outer tube;

ii) rotating the inner hollow tube such as to cause the cutting tool to rotate adjacent the cutting window;

iii) applying suction to the suction lumen of the inner tube so as to cause tissue to be drawn into the cutting window and contacted by the rotating cutting tool;

iv) supplying RF energy between the intermediate and outer tubes such that tissue coming into contact therewith is coagulated;

v) manipulating the surgical instrument so as to cut and coagulate tissue in the region of the cutting window; and

vi) manipulating the surgical instrument so as to coagulate tissue in the region of the first slot in the outer tube.

7. A blade assembly for use with a surgical instrument and an electrosurgical generator, the blade assembly configured to coagulate tissue at a cutting window and at a distal tip of the blade assembly, the blade assembly comprising:

a) an electrically conductive outer tube including a distal end that defines a first opening aligned with the cutting window and defines a first slot aligned with the distal tip of the blade assembly;

b) an electrically conductive intermediate hollow tube defining a central passageway and a distal end, the distal end of the intermediate tube defining a first opening that is aligned with the cutting window, the intermediate tube extending coaxially within the outer tube;

c) first and second electrical contacts associated with the outer and intermediate tubes respectively, the first and second electrical contacts being electrically connected to respective poles of the electrosurgical generator;

d) an electrically insulating layer disposed between the intermediate and outer tubes, the insulating layer defining a first opening that is aligned with the cutting window and a first slot that is aligned with the distal tip of the blade assembly;

e) an inner hollow tube rotatably mounted coaxially within the intermediate tube, the inner tube providing a suction lumen; and

f) a cutting tool disposed at a distal end of the inner tube and accessible to the tissue through the cutting window, the cutting tool defining a cutting edge;

wherein rotation of the inner tube cuts tissue in the region of the cutting window, and the application of RF energy from the electrosurgical generator to the first and second contacts coagulates tissue at the cutting window and at the distal tip of the blade assembly.