Modular systems for treating tissue

• US 10,271,866 B2
• Filed: 10/31/2016
• Issued: 04/30/2019
• 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, III, Robert L., Chomas, James E., Merchant, Adnan I., Brian, III, Ben F.
• Primary Examiner(s): Eastwood, David C
• Application Number:
  US15/339,585
• Publication Number:
  US 20170042608A1
• Time in Patent Office: 911 Days
• 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 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 18/06 caused by chemical reaction , e.g. moxaburners
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 18/1815 using microwaves
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• 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 2017/320052 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 2017/3409 : including needle or instrument drives
• 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 2018/00434 : Neural system
• CPC Class Codes: A61B 2018/00452 : Skin
• CPC Class Codes: A61B 2018/00458 : Deeper parts of the skin, e.g. treatment of vascular disorders or port wine stains
• CPC Class Codes: A61B 2018/0047 : Upper parts of the skin, e.g. skin peeling or treatment of wrinkles
• CPC Class Codes: A61B 2018/00571 : for achieving a particular surgical effect
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00601 : Cutting
• CPC Class Codes: A61B 2018/00607 : Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/00648 : using more than one sensed parameter
• 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 2018/1415 : multiple blades
• CPC Class Codes: A61B 2018/1425 : Needle
• 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 2218/002 : Irrigation
• CPC Class Codes: A61B 90/02 : Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• CPC Class Codes: A61F 2/0059 : Cosmetic or alloplastic implants A61F2/10 - A61F2/16, A61F2/28 take precedence
• CPC Class Codes: A61F 2/0063 : Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61M 37/00 : Other apparatus for introducing media into the body for reproduction or fertilisation A61B17/425; apparatus for iontophoresis or cataphoresis A61N1/30; Percutany, i.e. introducing medicines into the body by diffusion through the skin salt baths A61H33/04
• 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

Devices and methods for performing subcutaneous surgery in a minimally invasive manner are provided. The methods include application of reduced air pressure in a recessed area of a handpiece placed over a section of skin and drawing the section of skin and subcutaneous tissue into the recessed area. In a subsequent step a tool is inserted through a tool conduit in the handpiece and through the skin into the subcutaneous tissue, enabling the performance of the desired surgery. Common surgical procedures include dissection and ablation. The devices and methods can be directed at the treatment of skin conditions like atrophic scars, wrinkles, or other cosmetic issues, at treatments like or promoting wound healing or preventing hyperhidrosis, or can be used for creating space for various implants.

Claims

1. A system for treating tissue, the system comprising:

a handpiece comprising;

a top,

sidewalls,

a chamber at least partially defined by the top and sidewalls,

a tool conduit comprising an entry hole,

a vacuum port in fluid communication with the chamber, the handpiece configured to elevate target tissue relative to surrounding tissue upon application of vacuum pressure to the chamber through the vacuum port, and

clip recesses;

a first tissue treatment tool comprising an injection device including;

a needle control module,

a needle extending from the needle control module,

a first guide pin extending from the needle control module, and

a supply tube extending from the needle control module, the supply tube configured to be fluidly coupled to a syringe;

a first guidance track comprising first clips configured to be coupled to the clip recesses of the handpiece, the first guidance track comprising injection guidance tracks, the first guide pin configured to move along the injection guidance tracks to guide the needle through the entry hole and into elevated target tissue;

a second tissue treatment tool comprising;

a cutting blade assembly comprising a cutting blade, the cutting blade assembly configured to be coupled to a motor module configured to reciprocate the cutting blade, and

a second guide pin extending from the cutting blade assembly; and

a second guidance track comprising second clips configured to be coupled to the clip recesses of the handpiece, the second guidance track comprising cutting guidance tracks, the second guide pin configured to move along the cutting guidance tracks to guide the cutting blade through the entry hole and into elevated target tissue and allow movement of the cutting blade in side-to-side directions in a plane parallel to the top of the handpiece.

2. The tissue treatment system of claim 1, wherein the tool conduit of the handpiece tapers inwardly from an outside of the handpiece to the entry hole.

3. The tissue treatment system of claim 1, wherein the top of the handpiece is transparent and comprises a reference feature.

4. The tissue treatment system of claim 1, wherein the first guidance track comprises a first guide pin entry conduit configured to receive the first guide pin of the first tissue treatment tool and wherein the second guidance track comprises a second guide pin entry conduit configured to receive the second guide pin of the second tissue treatment tool.

5. A system for treating tissue, the system comprising:

a handpiece comprising;

a chamber,

an entry hole,

a port in fluid communication with the chamber, the handpiece configured to elevate target tissue relative to surrounding tissue upon application of vacuum pressure to the chamber through the port, and

clip recesses;

a first tissue treatment tool comprising a needle;

a first guidance track comprising first clips configured to be coupled to the clip recesses of the handpiece, the first guidance track comprising injection guidance tracks configured to guide the needle through the entry hole and into elevated target tissue;

a second tissue treatment tool comprising a cutting blade; and

a second guidance track comprising second clips configured to be coupled to the clip recesses of the handpiece, the second guidance track comprising cutting guidance tracks configured to guide the cutting blade through the entry hole and into elevated target tissue and allow movement of the cutting blade in a plane parallel to the top of the handpiece.

6. The tissue treatment system of claim 5, wherein the handpiece comprises a tool conduit tapering inwardly from an outside of the handpiece to the entry hole.

7. The tissue treatment system of claim 5, wherein the handpiece comprises a transparent top comprising a reference feature.

8. The tissue treatment system of claim 5, wherein the handpiece comprises a top reversible between a first side and a second side to adjust a depth of the entry hole.

9. The tissue treatment system of claim 5, wherein the first guidance track comprises a first guide pin entry conduit configured to receive a first guide pin of the first tissue treatment tool and wherein the second guidance track comprises a second guide pin entry conduit configured to receive a second guide pin of the second tissue treatment tool.

10. A system for treating tissue, the system comprising:

a handpiece comprising;

a chamber, and

an entry hole,

the handpiece configured to elevate target tissue relative to surrounding tissue upon application of a force to the target tissue;

a first tissue treatment tool;

a first guidance track configured to be reversibly coupled to the handpiece, the first guidance track configured to guide the first tissue treatment tool through the entry hole and into elevated target tissue;

a second tissue treatment tool comprising a cutting blade; and

a second guidance track configured to be reversibly coupled to the handpiece, the second guidance track configured to guide the second tissue treatment tool through the entry hole and into elevated target tissue and allow movement of the second tissue treatment tool in a pattern different than that of the first guidance track.

11. The tissue treatment system of claim 10, wherein the handpiece comprises clip recesses, wherein the first guidance track comprises first clips configured to be coupled to the clip recesses of the handpiece, and wherein the second guidance track comprises second clips configured to be coupled to the clip recesses of the handpiece.

12. The tissue treatment system of claim 10, wherein the handpiece comprises a tool conduit tapering inwardly from an outside of the handpiece to the entry hole.

13. The tissue treatment system of claim 10, wherein the first tissue treatment tool comprises a needle, and wherein the first guidance track comprises injection guidance tracks configured to guide the needle.

14. The tissue treatment system of claim 10, wherein the second tissue treatment tool comprises a cutting blade, and wherein the second guidance track comprises cutting guidance tracks configured to guide the cutting blade.

15. The tissue treatment system of claim 14, wherein the cutting blade is deployable after insertion through the entry hole.

16. The tissue treatment system of claim 10, wherein the handpiece comprises a transparent top.

17. The tissue treatment system of claim 10, wherein the handpiece comprises a top reversible between a first side and a second side to adjust a depth of the entry hole.

18. The tissue treatment system of claim 10, wherein the handpiece comprises a port in fluid communication with the chamber and wherein the force comprises vacuum pressure.

19. The tissue treatment system of claim 10, wherein the first guidance track comprises a first guide pin entry conduit configured to receive a first guide pin of the first tissue treatment tool and wherein the second guidance track comprises a second guide pin entry conduit configured to receive a second guide pin of the second tissue treatment tool.

20. The tissue treatment system of claim 10, wherein the handpiece comprises a transparent top and a reference feature, wherein the first tissue treatment tool comprises a needle, wherein the first guidance track comprises injection guidance tracks configured to guide the needle, wherein the second tissue treatment tool comprises a cutting blade, and wherein the second guidance track comprises cutting guidance tracks configured to guide the cutting blade.