Method and apparatus for thread transection of a ligament

• US 9,381,033 B2
• Filed: 04/30/2012
• Issued: 07/05/2016
• Est. Priority Date: 04/30/2012
• Status: Active Grant

• Current Assignee: Joseph Guo
• Original Assignee: Joseph Guo
• Inventors: Guo, Joseph
• Primary Examiner(s): Miles, Jonathan
• Assistant Examiner(s): OBU, KENDRA NNEAMAKA
• Application Number:
  US13/460,246
• Publication Number:
  US 20130289596A1
• Time in Patent Office: 1,527 Days
• US Class Current: 1/1
• 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 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/320036 adapted for use within the carpal tunnel
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/3209 Incision instruments
• CPC Class Codes: A61B 2017/320028 with reciprocating movements
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• 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 2017/320078 Tissue manipulating surface
• CPC Class Codes: A61B 2017/320098 with transverse or torsional motion

Abstract

A method and apparatus for transecting soft tissue, such as a ligament, and more particularly, the transverse carpal ligament. A retrieval tool and a threadlike cutting element enable the method to performed in a minimally invasive manner. The cutting element is routed into position about the target ligament such that the cutting element both enters and exits the body from the same side of the ligament. The smooth exterior surface of the cutting element serves to provide for a kerf-less cut.

Claims

1. A method for transecting a ligament within a body, comprising the steps of:

providing a flexible thread-like cutting element having a smooth and non-abrasive surface and two ends;

routing said cutting element about said ligament so as to enter and exit said body from a first location transversely adjacent to said ligament; and

exerting force on the ends of said cutting element so as to achieve a kerf-less transection of said ligament;

wherein said routing step further comprises the steps of;

providing a substantially rigid retrieval tool;

extending said retrieval tool into said body at said first location and out of said body at a second location transversely adjacent to said ligament and opposite said first location so as to traverse said ligament on a first side thereof;

engaging said cutting element with said retrieval tool and retracting said tool to pull a first portion of said cutting element into said body at said second location and out of said body at said first location;

disengaging said first portion of said cutting element from said retrieval tool;

extending said retrieval tool from said first transversely adjacent location through said body toward said second location so as to traverse said ligament on a second side thereof opposite said first side; and

engaging said cutting element with said retrieval tool and retracting said tool to pull a second portion of said cutting element into said body at said second location and out of said body at said first location.

2. The method of claim 1, wherein a distal portion of said retrieval tool remains in the body at said first location while said first of portion of said cutting element is disengaged therefrom.

3. The method of claim 1, wherein said second portion of said cutting element is engaged by said retrieval tool at a location within said body.

4. The method of claim 3, wherein said cutting element has a rigid locator tool attached thereto to facilitate engagement with said retrieval tool within the said body and said locator tool is separated from said cutting element prior to retracting said retrieval tool.

5. The method of claim 1, wherein unequal forces are exerted on the ends of said cutting element to alternatingly pull said cutting element in opposite directions to transect said ligament.

6. The method of claim 1, wherein unequal forces are exerted on the ends said cutting element so as to pull said cutting element in a single direction to transect said ligament.

7. The method of claim 1, wherein substantially equal forces are simultaneously exerted on both ends of said cutting element to transect said ligament.

8. The method of claim 1, wherein an imaging device is relied upon to route said cutting element about said ligament.

9. The method of claim 1, wherein an imaging device is relied upon to visualize said retrieval tool within the body relative to said ligament.

10. The method of claim 9, wherein said imaging device comprises an ultrasound imaging device.

11. The method of claim 1, wherein said ligament comprises the transverse carpal ligament.

12. The method of claim 1, wherein a liquid is injected into the body in and around such ligament prior to said routing of said cutting element about said ligament so as to provide space for the extension of the retrieval tool thereinto.

13. The method of claim 1, wherein a protective tube is used in the method and the method further comprises a step of positioning the protective tube about said cutting element at said first location.

14. A method for transecting a segment of soft tissue within a body, comprising the steps of:

providing a flexible thread-like cutting element having a smooth and non-abrasive surface and two ends;

routing said cutting element about said segment of soft tissue so as to enter and exit said body from a first location transversely adjacent to said segment of soft tissue; and

exerting force on the ends of said cutting element so as to achieve a kerf-less transection of said segment of soft tissue;

wherein said routing step further comprises the steps of;

providing a substantially rigid retrieval tool;

extending said retrieval tool into said body at said first location and out of said body at a second location transversely adjacent to said segment of soft tissue and opposite said first location so as to traverse said segment of soft tissue on a first side thereof;

engaging said cutting element with said retrieval tool and retracting said tool to pull a first portion of said cutting element into said body at said second location and out of said body at said first location;

disengaging said first portion of said cutting element from said retrieval tool;

extending said retrieval tool from said first transversely adjacent location through said body toward said second location so as to traverse said segment of soft tissue on a second side thereof opposite said first side; and

engaging said cutting element with said retrieval tool and retracting said tool to pull a second portion of said cutting element into said body at said second location and out of said body at said first location.

15. The method of claim 14, wherein a distal portion of said retrieval tool remains in the body at said first location while said first of portion of said cutting element is disengaged therefrom.

16. The method of claim 14, wherein said second portion of said cutting element is engaged by said retrieval tool at a location within said body.

17. The method of claim 14, wherein unequal forces are exerted on the ends of said cutting element to alternatingly pull said cutting element in opposite directions to transect said segment of soft tissue.

18. The method of claim 14, wherein unequal forces are exerted on the ends said cutting element so as to pull said cutting element in a single direction to transect said segment of soft tissue.

19. The method of claim 14, wherein substantially equal forces are simultaneously exerted on both ends of said cutting element to transect said segment of soft tissue.

20. The method of claim 14, wherein an imaging device is relied upon to route said cutting element about said segment of soft tissue.

21. The method of claim 14, wherein an imaging device is relied upon to visualize said retrieval tool within the body relative to said segment of soft tissue.

22. The method of claim 21, wherein said imaging device comprises an ultrasound imaging device.