Methods, systems and devices for carpal tunnel release

• US 8,617,163 B2
• Filed: 05/20/2011
• Issued: 12/31/2013
• Est. Priority Date: 10/15/2004
• Status: Active Grant

• Current Assignee: Spinal Elements, Inc.
• Original Assignee: Baxano Surgical, Inc.
• Inventors: Bleich, Jeffery L.
• Primary Examiner(s): BOLES, SAMEH RAAFAT
• Application Number:
  US13/112,886
• Publication Number:
  US 20110224709A1
• Time in Patent Office: 956 Days
• Field of Search: 606/11, 606/9, 606/1, 606/63, 606 71-176
• US Class Current: 606/79
• CPC Class Codes: A61B 17/149 Chain, wire or band saws
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• 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 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• 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 17/3401 Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia local anaesthesia A61M19/00
• 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 17/3421 Cannulas
• CPC Class Codes: A61B 17/3496 Protecting sleeves or inner probes; Retractable tips for protecting body piercing guide needles A61M25/0612
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/320004 : abrasive
• CPC Class Codes: A61B 2017/320044 : Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/32006 : with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2017/3445 : used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3447 : Linked multiple cannulas
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00589 : Coagulation
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 90/04 : Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery protection of eyes against laser radiation A61F9/022
• CPC Class Codes: A61N 1/0551 : Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36017 : with leads or electrodes penetrating the skin

Abstract

Described herein are methods, systems and devices for cutting a ligament of a patient. In some embodiments, the method may include the steps of advancing a cannulated probe into a patient, advancing the distal end of the tissue modification device assembly posteriorly through the skin of the patient such that it exits the patient, exposing at least one tissue modification element of the tissue modification device assembly, and reciprocating at least a portion of the tissue modification device assembly by alternately pulling on proximal and distal portions of the tissue modification device assembly to draw the at least one tissue modification element across the ligament to cut the ligament, in some embodiments, the system may include a probe, a tissue modification device, and a sheath. The tissue modification device may include a proximal handle, at least one tissue modification element configured cut ligament, and a sharp distal tip.

Claims

1. A system for cutting a carpal ligament of a patient, the system comprising:

a probe configured to be advanced into a patient;

a tissue modification device, wherein tissue modification device comprises;

a proximal handle, at least one tissue modification element configured cut the ligament, a sharp distal tip, wherein the sharp distal tip is configured to be advanced anterior to the ligament of a patient and posteriorly through the skin of the patient such that it exits the patient;

a distal handle configured to couple to the sharp distal tip of the tissue modification device; and

a sheath configured to limit the exposure of the tissue modification element of tissue modification device, wherein the tissue modification device is configured for placement within the sheath such that tissue modification element is locally exposed by the sheath, further wherein the probe is a cannulated probe and the tissue modification device is configured to be deployed through the cannulated probe.

2. The system of claim 1, further comprising a nerve stimulator configured to couple to the tissue modification device to confirm correct placement of the tissue modification device.

3. A device for cutting a carpal ligament of a patient, the device comprising:

a proximal handle;

at least one tissue modification element configured cut the ligament;

a sharp distal tip, wherein the sharp distal tip is configured to be advanced anterior to the ligament of a patient and posteriorly through the skin of the patient such that it exits the patient;

a distal handle configured to couple to the sharp distal tip of the device; and

a sheath configured to limit the exposure of the tissue modification element, wherein the tissue modification element is configured for placement within the sheath such that tissue modification element is locally exposed by the sheath.

4. A system for cutting a carpal ligament of a patient, the system comprising:

a probe configured to be advanced into a patient;

a tissue modification device, wherein tissue modification device comprises;

a proximal handle, an abrasive surface configured cut the ligament, a sharp distal tip, wherein the sharp distal tip is configured to be advanced anterior to the ligament of a patient and posteriorly through the skin of the patient such that it exits the patient;

a distal handle configured to couple to the sharp distal tip of the tissue modification device; and

a protective cover disposed about the tissue modification device configured to limit the exposure of the abrasive surface, wherein the probe is a cannulated probe and the tissue modification device is configured to be deployed through the cannulated probe.

5. The system 4, further comprising a nerve stimulator configured to couple to the tissue modification device to confirm correct placement of the tissue modification device.