Devices and methods for tissue modification
First Claim
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1. A surgical tissue removal system, comprising:
- a flexible elongate body that is adapted to conform with the target anatomy, the body having at least one blade edge, where the flexible elongate body is a thin, flat, ribbon shaped flexible body that further comprises a profile having a width that is substantially greater than a height;
a region at the proximal end of the flexible elongate body configured to be pulled proximally to draw the blade edge proximally across impinging tissue;
a guidewire connector at the distal end of the flexible elongate body configured to removably connect to the end of a guidewire so that the end of the guidewire hooks into the guidewire connector at the distal end of the flexible elongate body so that the guidewire and flexible elongate body can be pulled toward the target anatomy to bend the flexible elongate body against the target anatomy and can be pulled distally to draw the cutting blade distally across impinging tissue, wherein the guidewire connector is configured to connect the flexible elongate body to the end of a guidewire while the flexible elongate body is pulled both proximally and distally and the blade edge is pulled proximally and distally across the impinging tissue to cut the impinging tissue; and
a barrier having at least one window, where the flexible body is slidably located within the barrier such that when the elongate body moves within the barrier, the blade edges move across the window.
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Abstract
Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures. The current invention includes specific tools that enable safe tissue modification in epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue abrasion device is provided including a thin belt or ribbon with an abrasive cutting surface. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired.
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Citations
38 Claims
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1. A surgical tissue removal system, comprising:
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a flexible elongate body that is adapted to conform with the target anatomy, the body having at least one blade edge, where the flexible elongate body is a thin, flat, ribbon shaped flexible body that further comprises a profile having a width that is substantially greater than a height; a region at the proximal end of the flexible elongate body configured to be pulled proximally to draw the blade edge proximally across impinging tissue; a guidewire connector at the distal end of the flexible elongate body configured to removably connect to the end of a guidewire so that the end of the guidewire hooks into the guidewire connector at the distal end of the flexible elongate body so that the guidewire and flexible elongate body can be pulled toward the target anatomy to bend the flexible elongate body against the target anatomy and can be pulled distally to draw the cutting blade distally across impinging tissue, wherein the guidewire connector is configured to connect the flexible elongate body to the end of a guidewire while the flexible elongate body is pulled both proximally and distally and the blade edge is pulled proximally and distally across the impinging tissue to cut the impinging tissue; and a barrier having at least one window, where the flexible body is slidably located within the barrier such that when the elongate body moves within the barrier, the blade edges move across the window. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A surgical tissue removal system, comprising:
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a flexible elongate body that is adapted to conform with the target anatomy, the body having at least one blade edge extending from one surface of the flexible elongate body, where the flexible elongate body is a thin, flat, ribbon shaped flexible body that further comprises a profile having a width that is substantially greater than a height; a region at the proximal end of the flexible elongate body configured to be pulled proximally to draw the blade edge proximally across impinging tissue; and a guidewire connector on the flexible elongate body configured to removably connect to the end of a guidewire so that the end of the guidewire connects into the guidewire connector at the distal end of the flexible elongate body so that the guidewire and flexible elongate body can be pulled toward the target anatomy to bend the flexible elongate body against the target anatomy and can be pulled distally to draw the blade edge distally across impinging tissue, wherein the guidewire connector is configured to connect the flexible elongate body to the end of a guidewire while the flexible elongate body is pulled both proximally and distally and the blade edge is pulled proximally and distally across the impinging tissue to cut the impinging tissue. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38)
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Specification