Methods for dissection of subcutaneous tissue

• US 9,044,259 B2
• Filed: 12/22/2014
• Issued: 06/02/2015
• 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:
  US14/579,821
• Publication Number:
  US 20150105811A1
• Time in Patent Office: 162 Days
• Field of Search: 606161-162, 606166-167, 606170-172, 606/185, 606/190, 606/191, 606/198, 600/131, 600/132, 600135-137, 600/565, 600/571, 604115-117, 604/542
• US Class Current: 1/1
• 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 by marking A61B2090/395
• 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 dissecting tissue, comprising:

positioning a handpiece comprising a recessed chamber and a vacuum port over a first region of target tissue comprising subcutaneous tissue;

wherein the recessed chamber comprises a top comprising an inner surface,

wherein the recessed chamber is in communication with the vacuum port;

coupling a guidance track to the handpiece;

applying vacuum pressure, via the vacuum port, to the recessed chamber, thereby causing the target tissue underlying the recessed chamber to contact the inner surface of the top;

engaging a cutting tool with the handpiece,

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

moving the cutting tool relative to the handpiece to insert the distal end of the cutting blade into the recessed chamber and into the subcutaneous tissue and further moving the cutting tool along the guidance track to move the distal end of the cutting blade in forward, reverse and side to side directions to cut structures within the subcutaneous tissue, thereby dissecting tissue.

2. The method of claim 1, wherein engaging the cutting tool comprises inserting the distal end of the cutting blade through a conduit in the handpiece and wherein moving the cutting tool along the guidance track allows a portion of the tool to pivot about the conduit.

3. The method of claim 2, wherein the conduit is positioned in a wall of the recessed chamber and the conduit comprises a seal.

4. The method of claim 1, wherein the cutting tool comprises a guide pin comprising a flange,

wherein the guidance track comprises an undercut groove,

wherein moving the cutting tool along the guidance track comprises placing the guide pin in the guidance track,

wherein moving the cutting tool comprises moving the cutting tool in a predetermined pattern by tracing the guide pin along at least a portion of the guidance track,

wherein tracing the guide pin along at least a portion of the guidance track defines the forward, reverse and side to side movement of the distal end of the cutting blade within the subcutaneous tissue, and

wherein the placement of the guide pin in the guidance track prevents the tissue cutting tool from being lifted off the guidance track.

5. The method of claim 1, wherein the subcutaneous tissue is dissected at a depth of between 3 mm and 15 mm below a dermis of the target tissue.

6. The method of claim 1, further comprising removing the distal end of the cutting tool from the target tissue;

placing the handpiece over a second region of target tissue;

applying vacuum pressure to the recessed chamber, thereby causing the second region of target tissue to be elevated to contact the inner surface of the top;

engaging the cutting tool with the handpiece and moving the cutting tool along the guidance track to cause the distal end of the cutting tool to enter the recessed chamber to dissect the subcutaneous tissue of the second region of target tissue.

7. The method of claim 6, wherein the dissection within the second region of target tissue is at a depth that is different from the depth of the dissection within the first region of target tissue.

8. The method of claim 7, wherein the top of the recessed chamber is adjustable and the difference in depth is achieved by adjusting the top.

9. The method of claim 7, wherein the top further comprises a rigid upper lid, a rigid inner lid, and a bladder disposed between the rigid upper lid and rigid inner lid, wherein the rigid inner lid is configured to move up and down with respect to the handpiece, the rigid inner lid being at its lowest point when the bladder is fully expanded, and being at its highest point when the bladder is deflated.

10. The method of claim 7, wherein the top further comprises a threaded lid having an inner edge and an outer edge, wherein a rim of the recessed chamber is threaded, wherein the inner and outer edges of the threaded lid interact with the threaded rim of the recessed chamber, such that the threaded lid is configured to move up and down with respect to the recessed chamber when the threaded lid is rotated.

11. The method of claim 1, wherein movement of the cutting tool along the guidance track is microprocessor controlled.

12. The method of claim 1, wherein the issue is dissected in a plane that is parallel to the inner surface of the top.

13. The method of claim 1, wherein the cutting tool further comprises a motor that drives the cutting blade and wherein moving the cutting tool along the guidance track further comprises activating the motor to move the cutting blade.

14. The method of claim 13, wherein activating the motor moves the cutting blade in a reciprocating motion.

15. A method for dissecting tissue, comprising:

coupling a guidance platform comprising a guidance track to a handpiece comprising a recessed chamber and a vacuum port,

wherein the recessed chamber has a top comprising an inner surface;

positioning the recessed chamber of the handpiece over a first region of target tissue comprising subcutaneous tissue;

connecting a vacuum source to the vacuum port and applying vacuum pressure to the recessed chamber to cause the target tissue to contact the inner top surface of the recessed chamber;

engaging a base of a tissue dissection device comprising a cutting element with the guidance track of the guidance platform; and

moving the tissue dissection device along the guidance track while maintaining contact between the tissue dissection device and the guidance platform to cause the cutting element to move in forward, reverse and side to side directions within the recessed chamber to cut structures within the subcutaneous tissue, thereby dissecting tissue.

16. The method of claim 15, wherein the cutting element comprises a plurality of collapsible blades and the method further comprises deploying the plurality of blades from a collapsed position to an expanded position.

17. The method of claim 15, wherein movement of the tissue dissection device is microprocessor controlled.

18. The method of claim 15, wherein the guidance track of the guidance platform limits the motion of the cutting element within the recessed area to a pattern defined by the guidance track.

19. A method for dissecting tissue, comprising:

positioning a handpiece comprising a base, a recessed area defined by a perimeter wall having a conduit therethrough and a top surface over a region of tissue comprising subcutaneous tissue;

applying a force to the handpiece to move the tissue into the recessed area and into contact with the top surface;

engaging the handpiece with a cutting tool,

wherein the cutting tool comprises a proximal end and a distal end;

moving the cutting tool along the base of the handpiece to cause a portion of the cutting tool to pivot in an arc about the conduit and allow the distal end of the cutting tool to move in forward, reverse and side to side directions within the subcutaneous tissue positioned in the recessed area, thereby dissecting tissue.

20. The method of claim 19, wherein the movement of the cutting tool is defined by a guidance track operatively coupled to the handpiece, wherein the guidance track comprises a plurality of interconnected pathways.