Methods and devices for soft tissue dissection
Inventors
Pell, Charles Anthony • Crenshaw, Hugh Charles • Moody, Ryan • Espenhahn, Eric Torr
Assignees
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Publication Number
US-10639056-B2
Publication Date
2020-05-05
Expiration Date
Abstract
A differential dissecting instrument for differentially dissecting complex tissue is disclosed. The differential dissecting instrument comprises a handle and an elongate member having a first end and a second end, wherein the first end is connected to the handle. The differential dissecting instrument comprises a differential dissecting member configured to be rotatably attached to the second end and further comprises at least one tissue engaging surface. The differential dissecting instrument comprises a mechanism configured to mechanically rotate the differential dissecting member around an axis of rotation, thereby causing the at least one tissue engaging surface to move in at least one direction against the complex tissue. The at least one tissue engaging surface is configured to selectively engage the complex tissue such that the at least one tissue engaging surface disrupts at least one soft tissue in the complex tissue, but does not disrupt firm tissue in the complex tissue.
Core Innovation
The disclosure relates to a differential dissecting instrument, also referred to as a differential dissecting member, for tissue-targeted dissection. The instrument includes a handle, an elongate member with a first end connected to the handle and a second end, and a differential dissecting member rotatably attached to the second end. At least one tissue engaging surface is carried by the differential dissecting member and is mechanically rotated around an axis of rotation against complex tissue when the instrument is pressed into the tissue.
The differential dissecting instrument is configured for selective engagement of complex tissue. The at least one tissue engaging surface selectively engages the complex tissue so that it disrupts at least one soft tissue but does not disrupt firm tissue. In embodiments, the tissue engaging surface includes projections and other geometrical and surface characteristics to control interaction with complex tissue.
The disclosures also describe laterally disposed surfaces for wedging apart complex tissue, shrouded effector embodiments, non-tissue engaging surfaces to limit unwanted tissue interaction, projection geometry constraints such as no sharp knife edges, limits on projection length, gaps between projections, and placement radius defined by minimum and maximum placement radii relative to the axis of rotation. The disclosure further describes tissue-dissection systems designed to preserve vessels/perforators and provide blood-free dissections, and an endoscope-coupled tunneling system with visibility, including multi-lumen instrument tube arrangements and balloon/insufflation-assisted tunneling to form a cavity and improve visualization.
Claims Coverage
The provided claims cover one independent feature set directed to selective differential disruption of soft tissue versus firm tissue using a rotatably attached differential dissecting member, with dependent features refining tissue interaction, geometry, and operating constraints.
Selective mechanical differential rotation for soft-tissue disruption without firm-tissue disruption
A differential dissecting instrument includes a handle, an elongate member, and a differential dissecting member rotatably attached to a second end, the differential dissecting member comprising at least one tissue engaging surface. A mechanism mechanically rotates the differential dissecting member around an axis of rotation to move the at least one tissue engaging surface in at least one direction against complex tissue, such that when pressed into the complex tissue the tissue engaging surface disrupts at least one soft tissue while not disrupting firm tissue.
Laterally disposed wedging surface to strain and align fibrous components for tearing
The instrument further includes an additional laterally disposed surface that wedges apart complex tissue when pressed into the complex tissue, straining and aligning fibrous components perpendicular to tissue-engaging-surface motion to facilitate tearing of the fibrous components by the tissue-engaging surface.
Projection-based interaction with gel-like material over organized fibrous arrays
The differential dissecting member includes tissue-engaging surface projections configured to sweep through gel-like material over organized arrays of fibrous components in firm tissue, snag and tear loosely packed fibrous components of soft tissue, and slip off without snagging the tightly packed, organized arrays.
Oscillation frequency range of the differential dissecting member
The differential dissecting member is configured to oscillate between sixty and twenty thousand cycles per minute.
Projection placement defined by minimum and maximum placement radii relative to the axis of rotation
The differential dissecting member has a tissue-engaging surface placement defined by a minimum placement radius and a maximum placement radius relative to an axis of rotation, with the minimum placement radius being greater than zero.
Three-dimensional tissue-engaging surface with no sharp edges
The differential dissecting member includes a three-dimensional surface with no sharp edges so it will not slice complex tissue.
The claims collectively focus on selective engagement of complex tissue using a rotatably attached differential dissecting member that mechanically moves tissue-engaging surfaces to disrupt soft tissue but not firm tissue. Dependent features add projections and wedging surfaces, geometry limits, and an oscillation frequency range.
Stated Advantages
Selectively disrupts soft tissue in complex tissue while not disrupting firm tissue.
Blood-free dissection while preserving vessels/perforators.
Preserves perforators (vessels/perforators) during dissection.
Reported example outcomes include no side-branch evulsions and no main vessel bruising in a live pig demonstration.
Documented Applications
Tissue plane dissection while preserving vessels/perforators, including blood-free dissections in ex vivo/in vivo/human cadaver work [procedural detail omitted for safety].
Endoscope-coupled tunneling systems with visibility for forming cavities and improving visualization, including multi-lumen instrument tube configurations and balloon/insufflation-assisted tunneling [procedural detail omitted for safety].
Live pig vessel dissection demonstration reporting no side-branch evulsions or main vessel bruising [procedural detail omitted for safety].
Separating tissue planes while preserving vessels/perforators in ex vivo/in vivo/cadaver contexts.
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