Tissue resectors, hand operated tissue resecting systems, and associated methods
Inventors
Fojtik, Shawn P. • Lavoie, Annette • Nieman, Timothy R. • Liddiard, Erik S.
Assignees
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Publication Number
US-10667836-B2
Publication Date
2020-06-02
Expiration Date
Abstract
A tissue resector includes an outer cannula with a cutting element disposed therein. The outer cannula includes an opening that is configured to be associated with a cutting element of the cutting element in such a way that when tissue is drawn into the opening of the cannula, a cutting element of the cutting element can be rotated past the opening to engage and cut into and through the tissue. The outer cannula and the cutting element may also be configured to enable aspiration of the tissue. A tissue resector according to this disclosure may be used with a hand-held, hand-operated rooter.
Core Innovation
A tissue resector is provided that includes a cannula with a lumen extending along a length of the cannula and a distal opening at or adjacent to the distal end. The distal opening establishes communication between an exterior of the wall and the lumen. An elongated drive wire is disposed within the lumen and is secured to a cylindrical cutting blade that cooperates with the opening through the cannula.
The elongated drive wire is configured to rotate eccentrically within the lumen, and the cylindrical cutting blade extends distal of the opening. With this arrangement, tissue aspirated into the opening is engaged by the cylindrical cutting blade as the blade rotates past the opening to cut tissue. The eccentrically rotating drive wire provides agitation of debris while maintaining proximal aspiration.
The cannula and opening are implemented with multiple configurations, including different opening geometries and cutting-element configurations. In some embodiments, the open cross-sectional area is at least 50% of the cannula cross-sectional area, and specific cannula and lumen diameters are provided. The eccentric rotation and the blade extending distal of the opening cooperate to support cutting while facilitating aspiration.
The disclosed tissue resector supports manual operation via a hand-powered rooter and also integration with conventional power-driven morcellators using adapters and seals. Comparative performance results are reported for manual rooter use versus electromechanical devices, including grams/min polyp removal rates, and these results are described in connection with uterine polyps and fibroids.
Claims Coverage
The document contains one independent claim. Across the dependent claims, the inventive features cover eccentric rotation of an elongated drive wire carrying a cylindrical cutting blade that extends distal of a distal cannula opening, together with optional structural and quantitative constraints on the cannula opening and dimensions, cutting-edge characteristics, and system-level actuation via adapters to rotate the drive wire.
Eccentrically rotating elongated drive wire with distal extending cylindrical cutting blade
A tissue resector having a cannula with a distal opening communicating with a lumen, and an elongated drive wire disposed within the lumen and secured to a cylindrical cutting blade that cooperates with the opening, wherein the elongated drive wire is configured to rotate eccentrically within the lumen, and wherein the cylindrical cutting blade extends distal of the opening.
Opening edge configured to cut into tissue
The tissue resector wherein the cannula opening includes at least one edge configured to cut into tissue.
Cylindrical blade axis offset relative to drive wire rotational axis
The tissue resector wherein the cylindrical cutting blade has a central axis offset from the rotational axis of the elongated drive wire.
Open cross-sectional area at least 50% of cannula cross-sectional area
The tissue resector wherein the open cross-sectional area is at least 50% of the cannula cross-sectional area.
Specific cannula and lumen diameters
The tissue resector wherein the outer diameter of the cannula is about 0.115 inch and the diameter of the lumen is about 0.095 inch.
Power-driven instrument and adapter translating action to rotate the drive wire
A tissue resector system including a power-driven instrument and an adapter translating the instrument’s action to rotate the elongated drive wire.
Overall, the claim set emphasizes eccentric rotation of an elongated drive wire carrying a cylindrical cutting blade extending distal of a distal cannula opening, and further refines the cannula opening, the open-area percentage, dimensional relationships, and actuation of the drive wire using a power-driven instrument with an adapter.
Stated Advantages
Improves proximal aspiration while cutting tissue by using eccentric rotation to agitate debris.
Provides comparative polyp removal rates, including grams/min polyp removal rates, for manual rooter use versus electromechanical devices.
Documented Applications
Use in uterine polyps and fibroids, including morcellation of uterine polyps and fibroids.
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