Medical device for removing an implanted object

• US 9,603,618 B2
• Filed: 02/20/2015
• Issued: 03/28/2017
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Original Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Inventors: Grace, Kenneth P., Lee, Weston H., Carver, Robert
• Primary Examiner(s): Ou, Jing
• Application Number:
  US14/627,851
• Publication Number:
  US 20150258333A1
• Time in Patent Office: 767 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 17/320016 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 17/3205 Excision 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 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/50 Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body locating otherwise A61B5/06; locating by radiation A61B6/00; removing calculi A61B17/22; from the eyes A61F9/00709
• CPC Class Codes: A61B 2017/00986 Malecots, e.g. slotted tubes, of which the distal end is pulled to deflect side struts
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0573 chacterised by means penetrating the heart tissue, e.g. helix needle or hook
• CPC Class Codes: A61N 2001/0578 having means for removal or extraction

Abstract

Methods and devices for separating an implanted object, such as a pacemaker lead, from tissue surrounding such object in a patient'"'"'s vasculature system. Specifically, the surgical device includes a handle, an elongate sheath and a circular cutting blade that extends from the distal end of the sheath upon actuating the handle. The circular cutting blade is configured to engage the tissue surrounding an implanted lead and cut such tissue in a coring fashion as the surgical device translates along the length of the lead, thereby allowing the lead, as well as any tissue remaining attached to the lead, to enter the device'"'"'s elongate shaft. The surgical device has a barrel cam cylinder in the handle assembly that imparts rotation of the blade and a separate cam mechanism in the tip of outer sheath assembly that imparts and controls the extension and retraction of the blade. The barrel cam cylinder and cam mechanism cooperate to cause the blade to rotate in a first direction and extend from and retract in the outer sheath due to a first actuation of the handle and to rotate in a second direction and extend and retract in the outer sheath due to a second actuation of the handle.

Claims

1. A device for removing an implanted object from a body vessel, the device comprising:

a sheath assembly comprising an outer sheath assembly and an inner sheath assembly, and a pin;

the outer sheath assembly comprising an outer sheath and an outer band, the outer band coupled to the pin;

the inner sheath assembly comprising an inner sheath and a tip, wherein the tip has a cutting surface;

the inner sheath comprising a proximal end and a distal end, wherein the distal end of the inner sheath is coupled to the tip;

the tip comprising a cam slot for receipt of and cooperation with the pin; and

a handle assembly comprising a trigger and a barrel cam cylinder, the trigger comprising a trigger pin, the barrel cam cylinder comprising a barrel cam cylinder slot for receipt and cooperation with the trigger pin, wherein the proximal end of the inner sheath is coupled to the barrel cam cylinder such that;

(1) upon a first actuation of the trigger to proximally move the trigger pin in a longitudinal direction, the barrel cam cylinder rotates in a first direction, thereby causing the tip to rotate in the first direction while the tip moves longitudinally; and

(2) upon a second actuation of the trigger to proximally move the trigger pin in the longitudinal direction, the barrel cam cylinder rotates in a second direction, thereby causing the tip to rotate in the second direction while the tip moves longitudinally;

wherein the barrel cam cylinder slot comprises an intersection in which a path defined by the barrel cam cylinder slot crosses itself, and the handle assembly further comprises a follower guide rotatably carried by the barrel cam cylinder, the follower guide engaging the trigger pin to guide the trigger pin straight through intersection during both the first actuation of the trigger and the second actuation of the trigger.

2. The device of claim 1, wherein the outer sheath assembly is stationary and the inner sheath assembly is capable of rotating.

3. The device of claim 1, wherein the pin couples the tip of the inner sheath assembly to the outer band of the outer sheath assembly.

4. The device of claim 1, wherein the handle assembly further comprises a spring assembly coupled to the trigger.

5. The device of claim 4, wherein the spring assembly is a constant force spring.

6. The device of claim 1, wherein the follower guide comprises:

a first wall that engages the trigger pin to guide the trigger pin straight through intersection during the first actuation of the trigger; and

a second wall that engages the trigger pin to guide the trigger pin straight through intersection during the second actuation of the trigger.

7. The device of claim 6, wherein the first wall is a first diagonally-extending wall and the second wall is a second diagonally-extending wall.

8. The device of claim 7, wherein the first diagonally-extending wall is a first curved wall and the second diagonally-extending wall is a second curved wall.

9. The device of claim 1, wherein the tip extends from and retracts into the outer band while the barrel cam cylinder rotates in the first direction.

10. The device of claim 9, wherein the tip extends from and retracts into the outer band while the barrel cam cylinder rotates in the second direction.

11. The device of claim 1, wherein the tip extends from and retracts into the outer band while the barrel cam cylinder rotates in the second direction.

12. A device for removing an implanted object from a body vessel, the device comprising:

a sheath comprising a proximal end and a distal end;

a tip coupled to the distal end of the sheath, wherein the tip has a cutting surface;

a handle assembly rotatably carrying the sheath, the handle assembly comprising;

a trigger comprising a trigger pin;

a barrel cam assembly comprising;

a barrel cam cylinder comprising a barrel cam cylinder slot for receipt and cooperation with the trigger pin, the barrel cam cylinder slot comprising a first slot portion and a second slot portion;

a follower guide rotatably carried by the barrel cam cylinder;

wherein upon a first actuation of the trigger to proximally move the trigger pin in a longitudinal direction, the follower guide urges the trigger pin to traverse the first slot portion, thereby causing the barrel cam cylinder and the tip to rotate in a first direction; and

wherein upon a second actuation of the trigger to proximally move the trigger pin in the longitudinal direction, the follower guide urges the trigger pin to traverse the second slot portion, thereby causing the barrel cam cylinder and the tip to rotate in a second direction.

13. The device of claim 12, wherein the follower guide comprises an aperture through which the trigger pin extends for receipt in and cooperation with the barrel cam cylinder slot.

14. The device of claim 13, wherein the follower guide further comprises:

a first wall that defines, in part, the aperture, the first wall engaging the trigger pin to urge the trigger pin to traverse the first slot portion during the first actuation of the trigger; and

a second wall that defines, in part, the aperture, the second wall engaging the trigger pin to urge the trigger pin to traverse the second slot portion during the second actuation of the trigger.

15. The device of claim 14, wherein the first wall is a first diagonally-extending wall and the second wall is a second diagonally-extending wall.

16. The device of claim 12, wherein the barrel cam cylinder slot comprises an intersection in which the first slot portion crosses the second slot portion, and the follower guide (1) inhibits the trigger pin from traversing the second slot portion during the first actuation of the trigger, and (2) inhibits the trigger pin from traversing the first slot portion during the second actuation of the trigger.

17. The device of claim 12, wherein the follower guide is rotatable from a first position to a second position and vice versa relative to the barrel cam cylinder, in the first position the follower guide urges the trigger pin to traverse the first slot portion upon the first actuation of the trigger, thereby causing the barrel cam cylinder and the tip to rotate in the first direction, and in the second position the follower guide urges the trigger pin to traverse the second slot portion upon the second actuation of the trigger, thereby causing the barrel cam cylinder and the tip to rotate in the second direction.

18. The device of claim 17, wherein the device further includes a mechanism that inhibits the follower guide from rotating relative to the barrel cam cylinder, the mechanism including:

a protrusion carried by the barrel cam cylinder;

a first spring prong carried by the follower guide, the first spring prong engaging the protrusion in the first position to inhibit the follower guide from rotating toward the second position; and

a second spring prong carried by the follower guide, the second spring prong engaging the protrusion in the second position to inhibit the follower guide from rotating toward the first position.

19. The device of claim 18, wherein the protrusion comprises a curved recess, the first spring prong includes a first curved tip that engages the curved recess in the first position to inhibit the follower guide from rotating toward the second position, and the second spring prong includes a second curved tip that engages the curved recess in the second position to inhibit the follower guide from rotating toward the first position.