Device for minimally invasive tendon sheath release
Inventors
Assignees
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Publication Number
US-8608765-B1
Publication Date
2013-12-17
Expiration Date
Abstract
A device and method for minimally invasive tendon sheath release is presented herein. The device and method enables a surgeon to cut (“open”) a pulley that is obstructing a nodule and keeping a tendon from sliding smoothly. A guide probe of the device is inserted through a small incision and is used to find the edge of the pulley. Once found, the probe is guided to an end of the pulley. After proper position is assured, a hemi-cannula is moved over the guide probe to isolate the pulley from the surrounding tissue. A cutting blade is then used to sever the pulley. A dilation device may be inserted prior to the insertion of the ball tipped guide probe to dilate the area.
Core Innovation
The invention relates to a minimally invasive tendon sheath release device and method for release of trigger finger and pulley, including a tendon, a pulley, and/or a nodule. The device is designed to permit a small incision while releasing the tendon sheath and pulley, and includes locating and positioning features that interface with a guide probe and surrounding guides at the distal end.
The device includes a handle having a cavity and a sheath having a proximal end and a distal end with a top portion and a bottom portion. A guide probe having a spherical tip is attached to the bottom portion of the distal end of the sheath, and a dorsal outrigger guide having a spherical tip is attached to the top portion of the distal end of the sheath. A cutting blade is disposed between the guide probe and the dorsal outrigger guide.
A hemi-cannula is disposed on the distal end of the sheath and includes a tubular structure with a rounded opening adapted to receive a device for minimally invasive tendon sheath release. The hemi-cannula is configured to move proximally to expose the guide probe or distally to contain the guide probe, thereby encasing and protecting the distal components while a pulley is severed. The disclosure further includes embodiments including a static cutting blade and a retractable cutting shaft with a blade deployment switch or trigger, as well as an optional dilation device with a tapered dilation tip encasing distal device components during incision dilation, with verification using fluoroscopy or ultrasound.
Claims Coverage
The independent claim covers a minimally invasive tendon sheath release device with a distal guide probe and dorsal outrigger guide arrangement and a movable hemi-cannula, yielding a structure in which the guide probe can be exposed or contained relative to a cutting blade positioned between the guides. The claim includes six inventive features, with dependent claims further specifying selected structural refinements of the sheath and cutting blade arrangement, and the sliding-means structure.
Minimally invasive tendon sheath release device with handle and sheath cavity
A handle having a cavity contained therein, and a sheath having a proximal and a distal end wherein the proximal end projects from the cavity and the distal end of the sheath has a top and a bottom portion.
Spherical-tip guide probe and dorsal outrigger guide
A guide probe having a spherical tip attached to the bottom portion of the distal end of the sheath, and a dorsal outrigger guide having a spherical tip attached at the top portion of the distal end of the sheath.
Cutting blade disposed between the guides
A cutting blade disposed between the guide probe and the dorsal outrigger guide.
Movable hemi-cannula with rounded opening and tubular structure
A hemi-cannula disposed on the distal end of the sheath comprising a tubular structure having a proximal end, a distal end, a top portion and a bottom portion, and a rounded opening disposed in the proximal end adapted to receive a device for minimally invasive tendon sheath release.
Tapered distal top portion and bottom portion extension limit
Wherein the top portion of the distal end is downwardly tapered, and wherein the bottom portion extends distally from the opening for less than half of the longitudinal distance of the tubular structure.
Sliding means to expose or contain the guide probe
A sliding means disposed at the proximal end of the top portion, wherein the hemi-cannula may be moved proximally to expose the guide probe or distally to contain the guide probe.
Across the independent claim, the core coverage combines a guide probe and a dorsal outrigger guide with spherical tips, a cutting blade positioned between them, and a movable hemi-cannula with a rounded opening and sliding means that exposes or contains the guide probe, with the distal geometry defined by a downwardly tapered top portion and a bottom portion extension limit.
Stated Advantages
Reduced incision size (about 90%–95% smaller).
Minimal surrounding tissue dissection.
Enhanced safety and precision.
Verification using fluoroscopy or ultrasound.
Documented Applications
Release of trigger finger/pulley involving a tendon sheath and a pulley (including an A1 pulley), and related release scenarios discussed in the disclosure.
DeQuervain's release.
Carpal tunnel release.
Tarsal tunnel release.
Posterior tibial tendon release.
Plantar fascial release.
Fasciotomy.
Compartment syndromes.
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