Methods and handpiece for use in tissue dissection

• US 8,979,881 B2
• Filed: 05/29/2014
• Issued: 03/17/2015
• Est. Priority Date: 08/07/2009
• Status: Active Grant

• Current Assignee: Ulthera Inc. (Merz Pharma GmbH & Company Kgaa)
• Original Assignee: Ulthera Inc. (Merz Pharma GmbH & Company Kgaa)
• Inventors: Clark, Robert L III, Chomas, James E., Merchant, Adnan I., Brian, Ben F. III
• Primary Examiner(s): EASTWOOD, DAVID C
• Application Number:
  US14/290,907
• Publication Number:
  US 20140277048A1
• Time in Patent Office: 292 Days
• Field of Search: 606161-162, 606166-167, 606170-172, 606/185, 606190-191, 606/198, 600131-132, 600135-137, 600/565, 600/571, 604115-117, 604/542
• US Class Current: 606/172
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• 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 17/3201 Scissors for biopsy A61B10/02
• CPC Class Codes: A61B 17/32093 for skin incisions
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00747 Dermatology
• CPC Class Codes: A61B 2017/00761 Removing layer of skin tissue, e.g. wrinkles, scars or cancerous tissue
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61B 2017/320028 with reciprocating movements
• CPC Class Codes: A61B 2017/32004 having a laterally movable cutting member at its most distal end which remains within the contours of said end
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments
• CPC Class Codes: A61B 2017/320056 Tunnelers
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3407 : including a base for support on the body
• CPC Class Codes: A61B 2018/0016 : Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00291 : using suction
• CPC Class Codes: A61B 2018/00452 : Skin
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/143 : multiple needles
• CPC Class Codes: A61B 2018/1432 : curved
• CPC Class Codes: A61B 2090/0811 : for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/0815 : Implantable devices for insertion in between organs or other soft tissues
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61H 2201/0207 : heated
• CPC Class Codes: A61H 2201/10 : with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
• CPC Class Codes: A61H 2201/105 : with means for delivering media, e.g. drugs or cosmetics
• CPC Class Codes: A61H 2207/00 : Anti-cellulite devices
• CPC Class Codes: A61H 23/0245 : with ultrasonic transducers, e.g. piezoelectric
• CPC Class Codes: A61N 1/306 : Arrangements where at least part of the apparatus is introduced into the body
• CPC Class Codes: A61N 1/327 : for enhancing the absorption properties of tissue, e.g. by electroporation
• CPC Class Codes: A61N 1/328 : for improving the appearance of the skin, e.g. facial toning or wrinkle treatment
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 2007/0008 : Destruction of fat cells
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A dermatological skin treatment device is provided. The device comprises a handpiece and a cutting tool, wherein the tool is inserted through the conduit and percutaneously inserted into a tissue disposed within a recessed area of the handpiece. The device and method cut the fibrous structures under the skin that cause cellulite at an angle substantially parallel to the surface of the skin and replace these structures with a non-cellulite forming structure by deploying a highly fibrous mesh through a single needle hole to create a highly fibrous layer directly or through wound healing processes.

Claims

1. A method for dissection of subcutaneous tissue, comprising:

positioning a handpiece comprising a base, a conduit through a side of the handpiece and a tissue engaging chamber over a first region of target tissue,

wherein the tissue engaging chamber is configured to allow elevation of a portion of the target tissue into the tissue engaging chamber, relative to surrounding tissue;

coupling a guidance device to the handpiece,

wherein the guidance device comprises a guidance track;

elevating the target tissue into the tissue engaging chamber to a first position that is elevated relative to the surrounding tissue;

engaging a cutting tool with the handpiece,

wherein the cutting tool comprises a cutting blade with a distal end and a proximal end,

wherein the cutting tool comprises a guide pin that interacts with the guidance track of the guidance device when the cutting tool is engaged with the handpiece;

piercing the elevated tissue with the distal end of the cutting blade and advancing the distal end of the cutting blade into a subcutaneous region underlying the elevated target tissue;

dissecting subcutaneous tissue in the subcutaneous region underlying the elevated target tissue with the distal end of the cutting blade by manipulating the cutting tool in a pattern defined by the interaction of the guidance track with the guide pin,

wherein manipulating the cutting tool comprises moving the guide pin of the cutting tool within and along the guidance track, and wherein said movement results in the distal end of the cutting blade moving laterally through the subcutaneous region underlying the elevated target tissue while a portion of the cutting tool pivots within the conduit.

2. The method of claim 1, wherein the handpiece comprises a vacuum aperture,

wherein elevating the target tissue comprises applying vacuum pressure, via said aperture, to said target tissue to elevate the target tissue into the tissue engaging chamber,

wherein said tissue is elevated into the tissue engaging chamber so that the surface of the target tissue contacts an inner top of the tissue engaging chamber,

wherein the conduit is positioned on the handpiece in a position so that the distal end of the cutting blade pierces the tissue at a desired treatment depth, and

wherein the desired treatment depth is between 4 and 20 millimeters below the surface of the target tissue.

3. The method of claim 1, wherein the tissue engaging chamber of the handpiece comprises an adjustable top configured to allow variable elevation of the target tissue.

4. The method of claim 3, wherein the adjustable top comprises a reversible top, and wherein reversal of the top varies the elevation of the target tissue from a first elevation to a second elevation.

5. The method of claim 3, wherein the adjustable top comprises a threaded top, and wherein rotation of the threaded top relative to the remainder of the tissue engaging chamber varies the degree of elevation of the target tissue.

6. The method of claim 1, wherein the cutting tool comprises a motor that drives the cutting blade and wherein dissecting the subcutaneous tissue further comprises activating the motor to move the blade.

7. The method of claim 6, wherein the motor moves the blade in a reciprocating pattern.

8. The method of claim 1, further comprising retracting the distal end of the cutting blade from the elevated tissue;

reducing or increasing the elevation of the target tissue from the first position to a second position of elevation, relative to the surrounding tissue;

piercing the elevated tissue at the second elevation with the distal end of the cutting blade and advancing the distal end of the cutting blade into a subcutaneous region underlying the target tissue elevated to the second elevation;

dissecting subcutaneous tissue in the subcutaneous region underlying the target tissue elevated to the second elevation with the distal end of the cutting blade by manipulating the cutting tool in a pattern defined by the interaction of the guidance track with the guide pin.

9. The method of claim 1, further comprising retracting the distal end of the cutting blade from the elevated tissue,

allowing the elevated target tissue to return to a non-elevated position;

removing and repositioning the handpiece at a second region of target tissue;

elevating the target tissue in the second region of target tissue into the tissue engaging chamber relative to the surrounding tissue;

piercing the elevated tissue in the second region of target tissue with the distal end of the cutting blade and advancing the distal end of the cutting blade into a subcutaneous region underlying the elevated target tissue in the second region;

dissecting subcutaneous tissue in the subcutaneous region underlying the elevated target tissue in the second region.

10. The method of claim 9, wherein the second region of target tissue is adjacent to the first region of target tissue with zero spacing between the first and second target regions.

11. The method of claim 1, wherein the guidance track comprises a plurality of interconnected pathways that limit the motion of the distal end of the cutting blade within the subcutaneous region underlying the elevated target tissue.

12. The method of claim 1, wherein the guidance track is configured to position the cutting tool parallel to a top surface of the handpiece.

13. A method for dissection of subcutaneous tissue, comprising:

positioning a handpiece comprising a base, a recessed area defined by an elevated perimeter wall and a top surface, and a vacuum port over a target tissue;

connecting the vacuum port to a source of vacuum pressure and applying vacuum pressure to said target tissue, thereby elevating the target tissue into the recessed area and into contact with the top surface, relative to surrounding tissue;

contacting a cutting tool with the base of the handpiece,

wherein the cutting tool comprises a cutting blade with a distal end and a proximal end,

wherein the distal end of the cutting blade is configured to at least partially extend laterally from the cutting tool;

advancing the cutting tool along the base of the handpiece so that the distal end of the cutting blade pierces the elevated tissue with the distal end of the cutting blade and the distal end of the cutting blade is positioned in a subcutaneous region underlying the elevated target tissue;

moving the cutting tool laterally and longitudinally along the base of the handpiece to cause the distal end of the cutting blade to move in a corresponding pattern in the subcutaneous region underlying the elevated target tissue and sever subcutaneous tissue within the subcutaneous region underlying the elevated target tissue.

14. The method of claim 13, wherein the lateral and longitudinal movement of the cutting tool along the base of the handpiece is defined by a guidance track coupled to said handpiece.

15. The method of claim 13, wherein the cutting tool comprises a cutter shaft that houses at least a portion of the proximal end of the cutting blade.

16. The method of claim 15, wherein the cutting blade is slidably disposed within the cutter shaft, in order to reduce unintended contact of tissue in the subcutaneous region underlying the elevated target tissue with the cutting blade.

17. The method of claim 13, wherein the cutting tool is configured to operably interact with a motor unit, wherein said interaction allows motorized movement of the cutting blade.

18. The method of claim 13, wherein the subcutaneous tissue is dissected at a fixed depth between 4 mm and 20 mm from the top surface.