Tissue removal device for neurosurgical and spinal surgery applications
원문보기
IPC분류정보
국가/구분
United States(US) Patent
등록
국제특허분류(IPC7판)
A61B-017/32
A61B-010/02
A61B-017/3207
A61B-017/00
A61B-019/00
출원번호
US-0631295
(2012-09-28)
등록번호
US-9028518
(2015-05-12)
발명자
/ 주소
Mark, Joseph L.
출원인 / 주소
Nico Corporation
대리인 / 주소
Murphy, Kristin L.
인용정보
피인용 횟수 :
1인용 특허 :
42
초록▼
A tissue cutting device that is especially suited for neurosurgical applications is disclosed and described. The device includes a handpiece and an outer cannula in which a reciprocating inner cannula is disposed. The inner cannula may include a hinge between a body section and a cutting section tha
A tissue cutting device that is especially suited for neurosurgical applications is disclosed and described. The device includes a handpiece and an outer cannula in which a reciprocating inner cannula is disposed. The inner cannula may include a hinge between a body section and a cutting section that allows the cutting section to pivot when the inner cannula reciprocates within the outer cannula. A tissue collector may also be provided and is in fluid communication with the lumen of the inner cannula. The inner cannula reciprocates at a rate that is greater than 1000 reciprocations per minute, and variable aspiration may also be provided to the device to control tissue traction and provide fine shaving and debulking.
대표청구항▼
1. A neurosurgical tissue removal device, comprising: a handpiece;an upper housing connected to a handpiece that extends proximally of the upper housing, wherein the handpiece has a first central longitudinal axis and includes an opening, and wherein a portion of the upper housing is positioned with
1. A neurosurgical tissue removal device, comprising: a handpiece;an upper housing connected to a handpiece that extends proximally of the upper housing, wherein the handpiece has a first central longitudinal axis and includes an opening, and wherein a portion of the upper housing is positioned within the opening of the handpiece such that a portion of the upper housing extends upwardly from a top surface of the handpiece, wherein the top surface of the handpiece extends proximal to a proximal end of the upper housingan outer cannula mounted in the upper housing and having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue;an inner cannula disposed in the outer cannula lumen and reciprocable within the outer cannula lumen, the inner cannula having an inner cannula lumen, a proximal end, an open distal end, a cutting edge at the distal enda motor positioned along the first central longitudinal axis; wherein the motor causes the inner cannula to reciprocate within the outer cannula lumen along a second longitudinal axis that is axially offset from the first central longitudinal axis, wherein the inner cannula reciprocates between a proximal position and a distal position at a rate that is at least about 1000 reciprocations per minute for creating discreet severed tissue segments. 2. The tissue removal device of claim 1, wherein the outer cannula opening has a width that varies longitudinally along the outer cannula and received tissue is compressed between the outer cannula cutting edge and the inner cannula cutting edge. 3. The tissue removal device of claim 1, wherein when the outer cannula opening is viewed in plan, the outer cannula opening is generally in the shape of a square. 4. The tissue removal device of claim 1, wherein when the outer cannula opening is viewed in plan, the outer cannula opening is generally in the shape of a trapezoid. 5. The tissue removal device of claim 1, wherein when the outer cannula opening is viewed in plan, the outer cannula opening is generally in the shape of the letter “D.” 6. The tissue removal device of claim 1, wherein the motor is connected to a cam that is operatively connected to the inner cannula, such that rotation of the 1 motor causes the cam to rotate to reciprocate the inner cannula. 7. The tissue removal device of claim 1, wherein the motor is connected to a cam follower, wherein the cam follower is connected to a cam, the cam is operatively connected to the inner cannula, and rotation of the motor causes the cam follower to rotate to reciprocate the inner cannula. 8. The tissue removal device of claim 6, wherein the cam has a continuous groove defined in an outer surface thereof and a proximal opening that is in communication with a proximal recess, wherein the groove has at least one pair of apexes, wherein the members of the at least one pair of apexes are spaced apart from one another along the length of the groove and wherein the proximal opening is configured to receive a motor shaft. 9. The tissue removal device of claim 6, wherein the motor has a rotating shaft that is arranged substantially parallel to the inner cannula and axially spaced apart from the inner cannula along the second longitudinal axis. 10. The tissue removal device of claim 1, further comprising a linear tissue aspiration path that extends from the inner cannula distal end to the inner cannula proximal end. 11. The tissue removal device of claim 1, further comprising a vacuum generator in fluid communication with the inner cannula lumen. 12. The tissue removal device of claim 1, wherein the outer cannula is rotatable with respect to the handpiece, and when the outer cannula is rotated with respect to the handpiece, the inner cannula rotates with the outer cannula to maintain a fixed circumferential orientation between the outer cannula and the inner cannula. 13. The tissue device of claim 1, further comprising a tissue collector in fluid communication with the inner cannula; wherein the tissue collector has a longitudinal axis, the inner cannula has a longitudinal axis, and the tissue collector longitudinal axis is substantially collinear with the inner cannula longitudinal axis. 14. A method of performing a neurosurgical procedure, comprising: providing a tissue removal device comprising:a handpiece and an upper housing connected to the handpiece such that a portion of the upper housing extends upwardly from a top surface of the handpiece, wherein the top surface of the handpiece extends proximally to a proximal end of the upper housing, and wherein the handpiece is positioned along a first central longitudinal axis,an outer cannula having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue, andan inner cannula disposed in the outer cannula lumen and reciprocable within the outer cannula lumen, the inner cannula having an inner cannula lumen, a proximal end,an open distal end, a cutting edge at the distal end,a motor positioned along the first central longitudinal axis; anda tissue collector in fluid communication with the inner cannula lumen; andactivating a motor along the first central longitudinal axis, thereby reciprocating the inner cannula within the outer cannula lumen along a second longitudinal axis that is axially offset from the first longitudinal axis while maintaining visibility of the second longitudinal axis while in an operational orientation,wherein the inner cannula reciprocates between a proximal position and a distal position, such that when the inner cannula is in the proximal position, the target tissue is received in the outer cannula opening, and when the inner cannula is in the distal position, a cutting section of the inner cannula pivots and the received target tissue is severed from surrounding tissue, wherein during the reciprocating step the inner cannula severs tissue at a rate that is at least about 1000 cuts per minute and creates discreet severed tissue segments that are delivered out of the proximal end of the inner cannula directly into the tissue collector. 15. The method of claim 14, further comprising aspirating the severed tissue in the proximal direction along the inner cannula lumen. 16. The method of claim 14, further comprising rotating the outer cannula with respect to the handpiece to align the outer cannula opening with the target tissue. 17. The method of claim 16, wherein the step of rotating the outer cannula with respect to the handpiece further comprises simultaneously rotating the inner cannula with the outer cannula to maintain a fixed circumferential orientation between the inner cannula and the outer cannula. 18. The method of claim 14, wherein the target tissue is one of spinal tissue, brain tissue. 19. The method of claim 14, further comprising creating an opening in the patient's anatomy and inserting the outer cannula into the opening and positioning the outer cannula proximate the target tissue. 20. The method of claim 14, wherein the target tissue comprises one of a tumor and a lesion. 21. The method of claim 14, wherein the method is an open surgical procedure. 22. A tissue removal system for a neurosurgical procedure, comprising: a tissue removal device comprising:an upper housing extending along a first longitudinal axis;a handpiece that extends in a proximal direction from the upper housing, wherein the handpiece extends along a second longitudinal axis that is offset from the first longitudinal axis, wherein the upper housing is connected to the handpiece such that the upper housing extends above a top surface of the handpiece, wherein the top surface of the handpiece extends proximally to a proximal end of the upper housing,an outer cannula mounted in the upper housing and having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue and wherein the proximal end of the outer cannula is positioned in the upper housing and is collinear with the first longitudinal axis,an inner cannula disposed in the outer cannula lumen and reciprocable within the outer cannula lumen along the first longitudinal axis, the inner cannula having an inner cannula lumen, a proximal end, an open distal end, a cutting edge at the distal end,a rotating motor positioned in the handpiece and disposed along the second longitudinal axis so as not to impede the visibility of the first longitudinal axis during reciprocation of the inner cannula within the outer cannula, the motor operable to reciprocate the inner cannula; anda tissue collector in fluid communication with the inner cannula lumen; anda vacuum generator in fluid communication with the inner cannula lumen, wherein the vacuum generator is operable to maintain the inner cannula lumen at a plurality of different vacuum levels for fine shaving and debulking. 23. The tissue removal system of claim 22, wherein the vacuum generator is operable to maintain the inner cannula lumen at vacuum level that is no greater than a preselected maximum vacuum level while allowing the vacuum level to be variably operated at less than the preselected vacuum level. 24. The tissue removal system of claim 23, further comprising a vacuum controller operatively connected to the vacuum generator, wherein the vacuum controller is manipulable to adjust the inner cannula vacuum level along a continuum of vacuum levels that are less than the preselected maximum vacuum level. 25. The tissue removal system of claim 24, wherein the vacuum controller comprises a foot pedal. 26. The tissue removal system of claim 25, wherein the foot pedal is depressible from a first position to a second position, and when the footpedal is depressed to the second position, the inner cannula vacuum level is the preselected maximum vacuum level. 27. The tissue removal system of claim 22, further comprising a linear tissue sample aspiration path extending from the inner cannula distal end to the inner cannula proximal end, whereby the inner cannula proximal end exits the upper housing and is in communication with the tissue collector that is positioned external to the upper housing and the handpiece. 28. The tissue removal system of claim 22, wherein the tissue collector is disposed between the inner cannula lumen and the vacuum generator. 29. A method of performing a neurosurgical procedure, comprising: providing a tissue removal system comprising a tissue removal device, wherein the tissue removal device comprises:a handpiece having a handpiece housing with a first central longitudinal axis,an upper housing connecting to a top portion of the handpiece such that the upper housing extends upwardly from a top surface of the handpiece, wherein the top surface of the handpiece extends proximally to a proximal end of the upper housing, wherein the upper housing extends along a second central longitudinal axis;an outer cannula having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue,an inner cannula disposed in the outer cannula lumen and reciprocable within the outer cannula lumen, the inner cannula having an inner cannula lumen, a proximal end, a distal end, a cutting edge at the distal end, anda rotary motor positioned within the handpiece housing along the first central longitudinal axis,inserting the outer cannula into a patient proximate a target tissue associated with the patient's neurological system;activating the rotary motor to reciprocate the inner cannula within the outer cannula lumen between a proximal position and a distal position along a cutting axis that is axially offset from the first central longitudinal axis while maintaining visibility of a cutting axis, such that when the inner cannula is in the proximal position, the target tissue is received in the outer cannula opening, and when the inner cannula is in the distal position, a cutting section pivots and the received target tissue is severed from surrounding tissue; andadjusting an inner cannula lumen vacuum level to aspirate tissue samples through the inner cannula lumen, wherein the inner cannula lumen vacuum level is less than a preselected maximum vacuum level. 30. The method of claim 29, wherein the step of adjusting the inner cannula lumen vacuum level comprises varying the inner cannula vacuum level along a continuum of vacuum levels that are less than the preselected maximum vacuum level. 31. The method of claim 29, wherein the tissue removal system further comprises a vacuum generator in fluid communication with the inner cannula lumen and a vacuum controller operatively connected to the vacuum generator, and the step of adjusting the inner cannula lumen vacuum level comprises manipulating the vacuum controller. 32. The method of claim 31, wherein the vacuum controller comprises a depressible foot pedal, and the step of adjusting the inner cannula lumen vacuum level comprises depressing the footpedal. 33. The method of claim 29, wherein the step of reciprocating the inner cannula within the outer cannula between the proximal position and the distal position further comprises reciprocating the inner cannula within the outer cannula at a substantially constant rate of reciprocation, and the substantially constant rate of reciprocation is at least about 1000 reciprocations per minute. 34. The method of claim 29, wherein the step of adjusting the inner cannula vacuum level comprises adjusting the inner cannula vacuum level within a range of from about 0 in Hg. to about 29 in. Hg. 35. The method of claim 29, further comprising observing a level of traction in tissue surrounding the target tissue, wherein the step of adjusting an inner cannula lumen vacuum level comprises adjusting the inner cannula lumen vacuum level to maintain a desired level of traction. 36. The method of claim 29, further comprising observing tissue surrounding the target tissue, wherein the step of adjusting an inner cannula lumen vacuum level comprises adjusting the inner cannula lumen vacuum level to avoid the occurrence of traction in the tissue surrounding the target tissue. 37. A tissue removal system, comprising: a handpiece and an upper housing connected to the handpiece, wherein the upper housing is positioned along a first longitudinal axis and wherein the handpiece is positioned along a second longitudinal axis such that the handpiece is axially offset from the upper housing, the handpiece having a to surface that extends proximally of the upper housing to a proximal end of the upper housing, and wherein a portion of the upper housing is positioned within an opening of the handpiece such that a portion of the upper housing extends upwardly from a top surface of the handpiece;an outer cannula positioned collinear with the first longitudinal axis so as to define a cutting axis, and having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue;an inner cannula disposed in the outer cannula lumen and reciprocable within the outer cannula lumen along the cutting axis, the inner cannula having an inner cannula lumen, a proximal end, an open distal end, a cutting edge at the distal end, a living hinge, a cutting section, and a body section, with the hinge being located between the cutting section and the body section, wherein the cutting section is pivotable when the inner cannula reciprocates within the outer cannula lumen;a tissue collector in fluid communication with the inner cannula lumen;a motor positioned in the handpiece and disposed along the second longitudinal axis so as to maintain visibility of the cutting axis, wherein the motor is operable to reciprocate the inner cannula; anda vacuum generator in fluid communication with the inner cannula lumen, wherein the vacuum generator is operable to maintain the inner cannula lumen at a plurality of different vacuum levels for fine shaving and debulking,wherein the inner cannula reciprocates within the outer cannula lumen between a proximal position and a distal position at a rate that is no less than about 1000 reciprocations per minute to create discreet severed tissue segments that are delivered to the tissue collector. 38. The tissue removal system of claim 37, wherein the outer cannula opening has a width that varies longitudinally along the outer cannula and received tissue is compressed between the outer cannula cutting edge and the inner cannula cutting edge. 39. The tissue removal system of claim 37, wherein the motor is connected to a cam that is operatively connected to the inner cannula, such that rotation of the motor causes the cam to rotate to reciprocate the inner cannula. 40. The tissue removal system of claim 39, wherein the cam has a length, a surface, a continuous groove defined in the surface, and the groove has at least one pair of apexes, wherein the members of the at least one pair of apexes are spaced apart from one another along the length of the groove. 41. The tissue removal system of claim 37, wherein the motor has a rotating shaft that is substantially parallel to the inner cannula and spaced apart from the inner cannula. 42. The tissue removal system of claim 37, further comprising a tissue aspiration path from the inner cannula distal end to the inner cannula proximal end. 43. The tissue removal system of claim 37, wherein the outer cannula is rotatable with respect to the handpiece, and when the outer cannula is rotated, the inner cannula rotates to maintain a fixed circumferential orientation between the outer cannula and the inner cannula. 44. The tissue removal system of claim 37, wherein the tissue collector has a longitudinal axis that is substantially collinear with the longitudinal axis of the inner cannula. 45. The tissue removal system of claim 37, wherein the handpiece, the inner cannula, and the outer cannula comprise a tissue removal device. 46. The tissue removal system of claim 37, wherein the vacuum generator is operable to maintain the inner cannula lumen at a vacuum level that is no greater than a preselected maximum vacuum level while allowing the vacuum level to be variably operated at less than the preselected vacuum level. 47. The tissue removal system of claim 46, further comprising a vacuum controller operatively connected to the vacuum generator, wherein the vacuum controller is manipulable to adjust the inner cannula vacuum level along a continuum of vacuum levels that are less than the preselected maximum vacuum level. 48. The tissue removal system of claim 47, wherein the vacuum controller is a foot pedal. 49. The tissue removal system of claim 48, wherein the foot pedal is depressible from a first position to a second position, and when the footpedal is depressed to the second position, the inner cannula vacuum level is the preselected maximum vacuum level. 50. The tissue removal system of claim 37, wherein the tissue collector is disposed between the inner cannula lumen and the vacuum generator.
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