Apparatus for rotating medical devices, systems including the apparatus, and associated methods

• US 9,107,691 B2
• Filed: 03/03/2011
• Issued: 08/18/2015
• Est. Priority Date: 10/19/2010
• Status: Active Grant

• Current Assignee: Minerva Surgical, Inc.
• Original Assignee: Distal Access, LLC
• Inventors: Fojtik, Shawn P.
• Primary Examiner(s): Crandall, Lynsey
• Assistant Examiner(s): PAHAKIS, MANOLIS Y
• Application Number:
  US13/039,831
• Publication Number:
  US 20120239008A1
• Time in Patent Office: 1,629 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1624 Drive mechanisms therefor
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2017/00469 for insertion of instruments, e.g. guide wire, optical fibre
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2017/2903 transferring rotary motion
• CPC Class Codes: A61B 2017/320775 Morcellators, impeller or propeller like means
• CPC Class Codes: A61B 2017/3409 including needle or instrument drives
• CPC Class Codes: A61M 2025/09116 Design of handles or shafts or gripping surfaces thereof for manipulating guide wires
• CPC Class Codes: A61M 25/01 Introducing, guiding, advancing, emplacing or holding catheters A61M25/10 takes precedence
• CPC Class Codes: A61M 25/09 Guide wires

Abstract

A rooter includes a rotatable element, an actuator for causing the rotatable element to rotate, and a coupling feature for rotatably coupling an elongated medical instrument to the rotatable element. The rotatable element may be at least partially contained within the interior of a housing or another element that remains substantially stationary as the actuator causes the rotatable element to rotate. The rooter may be used with a variety of elongated medical instruments, such as needles, drill bits, trocars, wires, catheters, tubes, and other elongated instruments that are used to enable or effect medical procedures within the body of a subject. The rooter may be used for a variety of purposes, including, without limitation, the introduction of an elongated medical instrument into the body of a subject or its removal from the subject'"'"'s body; removing, breaking up, or eliminating obstructions (e.g., blood clots, plaques, etc.) from the body of a subject; and obtaining samples from a subject'"'"'s body.

Claims

1. A maceration system, comprising:

a macerator wire comprising a distal end consisting of a loop, the loop configured to collapse upon placement thereof within introduction element and to re-expand upon removal thereof from the introduction element and to break up or macerate clots or blockages within a subject'"'"'s body by rotational movement; and

a rooter configured to engage and manually spin the macerator wire, the rooter including;

a cylindrical housing with an elongated slot extending longitudinally along a length of the cylindrical housing;

a rotatable element within an interior of the cylindrical housing, the rotatable element including a rotation facilitator;

an actuator including;

a cylindrical element residing within the cylindrical housing and surrounding the rotatable element, the cylindrical element configured to complementarily engage the rotation facilitator of the rotatable element to cause the rotatable element to rotate as the cylindrical element is translated along at least a portion of a length of the rotatable element;

an intermediate portion extending from the cylindrical element of the actuator and through the elongated slot of the cylindrical housing; and

an external element secured to the intermediate portion of the actuator outside of the cylindrical housing, the external element including a trigger protruding from the cylindrical housing, the trigger configured to receive at least one digit of a hand of an individual, to be translated along the length of the cylindrical housing by the at least one digit, to translate the intermediate portion of the actuator along the elongated slot of the cylindrical housing and to translate the cylindrical element of the actuator along at least a portion of the length of the cylindrical housing;

a conduit extending through the length of the rotatable element and communicating with both a distal end of the rooter and a proximal end of the rooter, the conduit configured to receive a portion of the macerator wire;

a coupling feature associated with the rotatable element, the coupling feature configured to engage the macerator wire in a manner that enables the rooter to spin the macerator wire during or separately from longitudinal movement of the macerator wire.

2. The maceration system of claim 1, wherein the loop of the macerator wire is a closed loop.

3. The maceration system of claim 2, wherein the distal end of the macerator wire is secured to another location of the macerator wire to form the closed loop.

4. The maceration system of claim 1, wherein the loop of the macerator wire is a substantially closed loop.

5. The maceration system of claim 1, wherein the loop of the macerator wire has a distal edge configured for introduction into a subject'"'"'s body.

6. The maceration system of claim 5, wherein the distal edge of the loop of the macerator wire is rounded.

7. The maceration system of claim 6, wherein the loop of the macerator wire has one of a circular shape, an elliptical shape and an oval shape.

8. A maceration system having an elongated medical instrument and a rooter for manually spinning the elongated medical instrument, the maceration system comprising:

the elongate medical instrument comprising;

a wire with;

a proximal end; and

an opposite distal end configured to be introduced into a body of a subject; and

a maceration element at the distal end of the wire, the maceration element having a looped configuration and being collapsible upon placement within a lumen of an introduction element and re-expandable upon removal thereof from the lumen and configured to break up clots or blockages within the body of the subject by rotational movement; and

the rooter comprising;

a cylindrical housing with an elongated slot extending longitudinally along a length of the cylindrical housing;

a rotatable element within an interior of the cylindrical housing, the rotatable element including a rotation facilitator;

an actuator including;

a cylindrical element residing within the cylindrical housing and surrounding the rotatable element, the cylindrical element configured to complementarily engage the rotation facilitator of the rotatable element to cause the rotatable element to rotate as the cylindrical element is translated along at least a portion of a length of the rotatable element;

an intermediate portion extending from the cylindrical element of the actuator and through the elongated slot of the cylindrical housing; and

an external element secured to the intermediate portion of the actuator outside of the cylindrical housing, the external element including a trigger protruding from the cylindrical housing, the trigger configured to receive at least one digit of a hand of an individual, to be translated along the length of the cylindrical housing by the at least one digit, to translate the intermediate portion of the actuator along the elongated slot of the cylindrical housing and to translate the cylindrical element of the actuator along at least a portion of the length of the cylindrical housing;

with both a distal end of the rooter and a proximal end of the rooter, the conduit configured to receive a portion of the macerator wire;

a coupling feature associated with the rotatable element, the coupling feature configured to engage the wire in a manner that enables the rooter to spin the wire during or separately from longitudinal movement of the wire.

9. The maceration system of claim 8, wherein the maceration element of the elongate medical instrument is configured to facilitate introduction of the distal end of the wire into the body of the subject.

10. The maceration system of claim 9, wherein the maceration element of the elongate medical instrument includes a rounded distal edge.

11. The maceration system of claim 10, wherein the maceration element of the elongate medical instrument comprises a loop.

12. The maceration system of claim 8, wherein a material from which the maceration element of the elongate medical instrument is formed renders the maceration element collapsible and re-expandable.