Surgical devices and related methods thereof

• US 9,320,540 B2
• Filed: 12/15/2009
• Issued: 04/26/2016
• Est. Priority Date: 09/02/2005
• Status: Active Grant

• Current Assignee: Madison Surgical Designs, LLC
• Original Assignee: Madison Surgical Designs, LLC
• Inventors: Badie, Behnam
• Primary Examiner(s): DELLA, JAYMI E
• Application Number:
  US12/638,619
• Publication Number:
  US 20100145330A1
• Time in Patent Office: 2,324 Days
• Field of Search: 606 46- 47, 606/113
• US Class Current: 1/1
• 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 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/3443 with means for adjusting the length of a cannula
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00208 actively driven, e.g. by a motor
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00446 Brain
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/141 Snare
• CPC Class Codes: A61B 2018/144 Wire
• CPC Class Codes: A61B 2090/103 : Cranial plugs for access to brain
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 90/10 : for stereotaxic surgery, e.g. frame-based stereotaxis

Abstract

Surgical devices and methods are configured to access areas of the brain while minimizing brain damage. A brain probe device for removing a lesion from a brain includes a cannula fixable to the skull to align the cannula with the lesion, a tubular stem within the cannula configured to be advanced to the lesion, and a rotatable cutting tube within the tubular stem. Expandable wire loops configured to cut tissue are attached to the distal end of the tubular stem. A loop expander and rotation motor mechanism is operably linked to the wire loops and configured to cause rotation and variable outward expansion of the wire loops. Tissue cut by the wire loops is removed through slots and a central lumen of the tubular stem. The cutting tube is rotatable to sever tissue drawn into the slots into smaller fragments that are removed through the central lumen via aspiration.

Claims

1. A brain probe device for use in removing a lesion from a brain of a patient, the brain probe device comprising:

a) a cannula having a proximal end and a distal end with a cannula axis therebetween, the cannula including a tubular extension adjacent the distal end, the tubular extension configured for insertion through a craniotomy in a skull of a patient and having a lumen therethrough, the cannula also including an attachment body proximally of and extending radially outwardly from the tubular extension, the attachment body having affixation features configured for affixing the cannula to the skull so as to maintain alignment of the cannula axis with the lesion;

b) a tubular central stem advanceable axially within the lumen of the cannula, wherein said tubular central stem comprises a proximal portion, a distal portion, and a distal end, wherein a plurality of tissue removal openings are formed in a first tube of the tubular central stem along said distal portion, wherein said tubular central stem includes a second tube rotatably aligned with the first tube of the tubular central stem and having radial openings configured to cooperate with the plurality of tissue removal openings so that the second tube provides a rotating side cutter configured to allow cutting of tissue with said plurality of tissue removal openings, and allow aspiration of said tissue through said plurality of tissue removal openings;

c) a probe sleeve, wherein said probe sleeve comprises a proximal portion, and a distal portion, wherein said proximal portion encloses most or all of said proximal portion of said tubular central stem;

d) a plurality of wire loops, wherein each of the plurality of wire loops is operably attached to said distal end of said tubular central stem and configured to be outwardly expanded from said tubular central stem from a contracted configuration to a preset expanded configuration the brain probe device being adjustable such that the preset expanded configuration can be selected from a plurality of expanded configurations, each of the plurality of expanded configurations having a different amount of expansion of the plurality of wire loops from the tubular central stem beyond which further expansion of the plurality of wire loops from the tubular central stem is blocked for the respective preset expanded configuration, and wherein said plurality of wire loops is;

i) configured for cutting the tissue for subsequent removal via the tubular central stem,

ii) configured for rotating around said distal portion of said tubular central stem so as to cut the tissue rotationally from the lesion about the cannula axis for subsequent removal via the tubular central stem, and

iii) configured to be outwardly expanded from the contracted configuration to the preset expanded configuration and contracted from the preset expanded configuration to the contracted configuration so as enable cutting of a desired volume of the tissue corresponding to a size of the lesion for subsequent removal via the tubular central stem;

(e) a loop expander and rotation motor mechanism which is operably linked to said plurality of wire loops and configured to cause rotation and outward expansion of said plurality of wire loops from the contracted configuration to the preset expanded configuration, wherein said loop expander and rotation motor mechanism is located in said probe sleeve, the loop expander and rotation motor mechanism being mounted on the proximal portion of the probe sleeve, the tubular central stem proximal portion including a spline-shaped elevator mechanism inside the probe sleeve, and wherein a first gear interconnects the loop expander and rotation motor mechanism and the elevator mechanism to enable rotation of the tubular central stem while permitting movement of the tubular central stem lengthwise within the probe sleeve;

(f) a rotational cutting motor mechanism attached to said tubular central stem to rotate the rotating side cutter independently of the loop expander and rotation motor mechanism, the rotational cutting motor mechanism including a rotational motor mounted on the proximal portion of the tubular central stem and a second gear interconnecting the rotational motor and the rotating side cutter to rotate the rotating side cutter independently of the loop expander and rotation motor mechanism and movement of the tubular central stem lengthwise within the probe sleeve; and

(g) an irrigation lumen configured for transferring irrigation fluid to irrigate said tissue in synchrony with aspiration of said tissue.

2. The brain probe device of claim 1, wherein each of the plurality of the wire loops has a proximal portion and a distal portion, and wherein said loop expander and rotation motor mechanism is configured to controllably displace said proximal portion of each of the plurality of the wire loops distally so as to enable-outward expansion of said plurality of wire loops from the contracted configuration to the preset expanded configuration.

3. The brain probe device of claim 1, further comprising an energy generator connection, wherein said energy generator connection is attached to said probe sleeve.

4. The brain probe device of claim 1, further comprising an irrigation fluid input port, wherein said irrigation fluid input port is attached to said probe sleeve and the probe sleeve includes the irrigation lumen.

5. The brain probe device of claim 1, further comprising a vacuum port connection, wherein said vacuum port connection is attached to said proximal portion of the tubular central stem.

6. The brain probe device of claim 1, further comprising a loop swivel attachment, wherein said plurality of wire loops is operably attached to said distal end of said tubular central stem via said loop swivel attachment.

7. The brain probe device of claim 1, wherein each of the plurality of wire loops is configured to expand out in a half-circle or egg-beater shape.

8. The brain probe device of claim 1, wherein said plurality of wire loops comprises two, three, four, five, or six wire loops.

9. The brain probe device of claim 1 in which the tubular central stem is positionable lengthwise within the probe sleeve to vary an amount by which the plurality of wire loops extend beyond the distal portion of said probe sleeve to control said outward expansion and contraction of said plurality of wire loops.

10. A system comprising:

a) a probe device comprising;

i) a tubular central stem, wherein said tubular central stem comprises a proximal portion, a distal portion, and a distal end, wherein a plurality of tissue removal openings are formed in said distal portion of said tubular central stem, wherein said tubular central stem includes a rotating side cutter configured to allow cutting of tissue with said plurality of tissue removal openings, and allow aspiration of said tissue through said plurality of tissue removal openings;

ii) a probe sleeve, wherein said probe sleeve comprises a proximal portion, and a distal portion, wherein said proximal portion encloses most or all of said proximal portion of said tubular central stem, the probe sleeve including an irrigation lumen configured for transferring irrigation fluid to irrigate said tissue in synchrony with aspiration of said tissue;

iii) at least one wire loop, wherein said at least one wire loop is operably attached to said distal end of said tubular central stem and extends beyond said distal portion of said probe sleeve, the at least one wire loop being configured to be outwardly expanded from said tubular central stem from a contracted configuration to a preset expanded configuration, the probe device being adjustable such that the preset expanded configuration can be selected from a plurality of expanded configurations, each of the plurality of expanded configurations having a different amount of expansion of the at least one wire loop from said tubular central stem beyond which further expansion of the at least one wire loop from the tubular central stem is blocked for the respective preset expanded configuration, and wherein said at least one wire loop is;

A) configured for cutting the tissue for subsequent removal via the tubular central stem,

B) configured to be rotated around said distal portion of said tubular central stem and

C) configured to be outwardly expanded from the contracted configuration to the preset expanded configuration and contracted from the preset expanded configuration to the contracted configuration;

iv) a loop expander and rotation motor mechanism which is operably linked to said at least one wire loop, the loop expander and rotation mechanism configured to cause rotation of said at least one wire loop around said distal portion of said tubular central stem and the outward expansion of said at least one wire loop from the contracted configuration to the preset expanded configuration, wherein said loop expander and rotation motor mechanism is located in said probe sleeve, the loop expander and rotation motor mechanism being mounted on the proximal portion of the probe sleeve, the tubular central stem proximal portion including a spline-shaped elevator mechanism inside the probe sleeve, and wherein a first gear interconnects the loop expander and rotation motor mechanism and the elevator mechanism to enable rotation of the tubular central stem while permitting movement of the tubular central stem lengthwise within the probe sleeve; and

v) a rotational cutting motor mechanism attached to said tubular central stem to rotate the rotating side cutter independently of the loop expander and rotation motor mechanism, the rotational cutting motor mechanism including a rotational motor mounted on the proximal portion of the tubular central stem and a second gear interconnecting the rotational motor and the rotating side cutter to rotate the rotating side cutter independently of the loop expander and rotation motor mechanism and movement of the tubular central stem lengthwise within the probe sleeve;

b) a probe actuation subsystem comprising;

i) an energy generating component coupled to the tubular central stem for energizing the at least one wire loop,

ii) an irrigation supply component for supplying fluid to the irrigation lumen; and

iii) a system controller component for selectably actuating the loop expander and rotation motor mechanism.

11. The system of claim 10, wherein said energy generating component comprises a radiofrequency (RF) generating component coupled electrically to the at least one wire loop at the proximal portion of the tubular central stem.

12. The system of claim 10, wherein the system further comprises a cannula sized and shaped so that said probe device can be inserted through said cannula.

13. The system of claim 10, wherein said at least one wire loop has a proximal portion and a distal portion, and wherein said loop expander and rotation motor mechanism is configured to controllably displace said proximal portion of said at least one wire loop distally so as to enable outward expansion of said at least one wire loop from the contracted configuration to the preset expanded configuration.

14. The system of claim 10, further comprising an energy generator connection, wherein said energy generator connection is attached to said probe sleeve.

15. The system of claim 10, further comprising an irrigation fluid input port, wherein said irrigation fluid input port is attached to said probe sleeve and in fluid communication with said irrigation lumen.

16. The system of claim 10, further comprising a vacuum port connection, wherein said vacuum port connection is operatively coupled to the proximal portion of the tubular central stem.

17. The system of claim 10, further comprising a loop swivel attachment, wherein said at least one wire loop is operably attached to said distal end of said tubular central stem via said loop swivel attachment.

18. The system of claim 10, wherein said at least one wire loop expands out in a half-circle or egg-beater shape having a size determined by a distance by which the tubular central stem and said at least one wire loop extends beyond said distal portion of said probe sleeve.

19. The system of claim 10, wherein said at least one wire loop comprises two, three, four, five, or six wire loops.

20. The system of claim 10, wherein said at least one wire loop is configured to outwardly expand away from the tubular central stem, said at least one wire loop having a diameter determined by a radial distance by which the tubular central stem and said at least one wire loop extend beyond said distal portion of said proximal probe sleeve, wherein said at least one wire loop is configured to axially lock relative to the tubular central stem when the rotation of said at least one wire loop about the cannula axis is ceased so as to prevent collapse of remaining tissue in response to severing and aspiration of the tissue of the lesion via the first and second tubes.