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-11253283-B2
Publication Date
2022-02-22
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 differential dissecting instrument (DDI) differentially dissects complex tissue by selectively engaging the complex tissue with at least one tissue-engaging surface. The DDI includes a handle and a flexible elongate member with a distal end and a proximal end, and a differential dissecting member rotatably attached to the distal end of the flexible elongate member and configured for mechanical oscillation around an axis of rotational oscillation so the tissue-engaging surface moves back and forth against the complex tissue.
The at least one tissue-engaging surface is configured to selectively engage the complex tissue such that, when the differential dissecting member is pressed into the complex tissue, it disrupts at least one soft tissue in the complex tissue but does not disrupt firm tissue in the complex tissue. The differential action is associated with the mechanical tissue behavior of soft tissues being disrupted while firm structures are avoided.
The mechanism includes at least one force-transmitting member having a distal end mechanically coupled to a first torque-point and a proximal end attached to a motive source, and in some implementations the first torque-point includes a scotch yoke pin follower with a scotch yoke and scotch yoke pin arrangement. The instrument is configured so that the axis of rotational oscillation is substantially transverse to the flexible elongate member, and at least one overload mechanism is configured to stop rotation of the differential dissecting member when a force exceeding at least a first threshold force is applied, with related refinements that stop oscillation, withdraw the differential dissecting member proximally, or stop the motive source.
Claims Coverage
Independent claims are provided for at least five claim families: clm-00001, clm-00017, clm-00018, clm-00019, and clm-00030. Across these independent claims, the inventive features focus on selectively disrupting soft tissue without disrupting firm tissue using an oscillating differential dissecting member driven through a flexible elongate member, with overload mechanisms that stop rotation and, in a refinement, stop the motive source.
Selective soft-tissue disruption without firm-tissue disruption
The at least one tissue-engaging surface is configured to selectively engage the complex tissue such that, when the differential dissecting member is pressed into the complex tissue, the at least one tissue-engaging surface moves back and forth across the complex tissue and disrupts at least one soft tissue in the complex tissue, but does not disrupt firm tissue in the complex tissue.
Flexible elongate member with rotatable differential dissecting member
The DDI includes a handle and a flexible elongate member connected to the handle, with a differential dissecting member rotatably attached to the distal end of the flexible elongate member, the differential dissecting member having an axis of rotational oscillation.
Mechanically oscillated differential dissecting member driven by a motive source
A mechanism mechanically oscillates the differential dissecting member around the axis of rotational oscillation thereby causing the at least one tissue-engaging surface to move back and forth against the complex tissue, where the differential dissecting member includes a first torque-point disposed proximal to the axis of rotational oscillation and the mechanism uses force-transmitting member(s) coupled to the first torque-point.
Oscillation drive via flexible force-transmitting members and motive source
At least one force-transmitting member having a distal end mechanically associated with the first torque-point and a proximal end attached to a motive source drives rotational oscillation of the differential dissecting member so the tissue-engaging surface moves back and forth against the complex tissue.
User-accessible control switch operatively associated with motor and power source
A control switch is operatively associated with the motor and the power source and is configured to be accessible by a user, for controlling operation of the motive source driving the oscillation.
Scotch yoke pin follower torque-point arrangement
The first torque-point includes a scotch yoke pin follower, and the mechanism includes a scotch yoke with a scotch yoke pin configured to engage the scotch yoke pin follower on the proximal end of the differential dissecting member, where motor rotation turns the at least one flexible drive shaft.
Overload mechanisms based on first threshold force
At least one overload mechanism is configured to, in response to at least a first threshold force, stop rotation of the differential dissecting member when a force exceeding the at least a first threshold force is applied to the differential dissecting member.
Overload mechanism stopping the motive source
At least one overload mechanism is configured to stop rotation of the differential dissecting member when the force exceeding the first threshold force is applied, and in a related dependent refinement the overload response stops the motive source when the applied force exceeds the first threshold force.
The independent claims share a common structure: a differential dissecting member with a tissue-engaging surface oscillated by a mechanically driven mechanism to selectively disrupt soft tissue without disrupting firm tissue, where oscillation is generated via force-transmitting member(s) connected to a motive source and supported by torque-point positioning, with overload mechanisms that stop rotation and, in a refinement, stop the motive source.
Stated Advantages
Disrupts at least one soft tissue in the complex tissue but does not disrupt firm tissue in the complex tissue.
Stops rotation of the differential dissecting member in response to a first threshold-force condition.
In a refinement, stops the motive source when the applied force exceeds the first threshold force.
Documented Applications
Laparoscopic, robotic, and single-incision/endoluminal (SILS/NOTES) use contexts are described for the differential dissecting instruments.
Plane separation and dissection around vessels, perforators, and collagenous bundles are described, including reportedly blood-free and organ-safe outcomes.
Endoscope-coupled tunneling systems with balloon inflation and insufflation are described for improving visibility and tissue tensioning.
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