1055results about "Abrasive surgical cutters" patented technology

Guidewire exchange systems, devices and methods, for positioning and actuating surgical devices in a desired position between two tissues in a patient's body are described. A guidewire may be coupled to a surgical device for positioning and actuating (e.g., urging against a target tissue). The guidewire may be exchanged between different surgical devices during the same procedure, and the guidewire and surgical devices may be releaseably or permanently coupled. The surgical device generally includes one or more guidewire coupling members. A system may include a guidewire and a surgical device having a guidewire coupling member. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures.

Disclosed is a tissue removal device having an outer tube with a resection window and an inner tube disposed within the outer tube. The inner tube is slidable and rotatable relative to the outer tube so that the distal end of the inner tube moves back and forth across the resection window to sever tissue extending therethrough. The inner tube may be driven to rotate at a speed of at least about 1100 rpm, to axially translate at a rate of at least about 1.5 cps, and with an advance ratio of no more than about 0.25. The drive system for controlling axial reciprocation and rotation of the inner tube may be totally mechanical.

Methods and devices described herein facilitate improved access of locations within the body by providing a variety of dissection modes on a single access device.

Hand-held minimally dimensioned diagnostic devices having integrated distal end visualization are provided. Also provided are systems that include the devices, as well as methods of using the devices, e.g., to visualize internal tissue of a subject.

Apparatus for controlling the deformation of an implant during deployment thereof, comprising: a force application mechanism for applying deformation force to the implant, by motion of a force applicator against the implant; and a restraint element positioning mechanism that positions a restraining element such that the deformation of the implant is controlled by restraint of the restraining element on allowable deformation; and a synchronizer that synchronizes the motion of the restraining element and the force applicator, to achieve a desired deformation of the implanted.

Sinusitis, mucocysts, tumors, infections, hearing disorders, choanal atresia, fractures and other disorders of the paranasal sinuses, Eustachian tubes, Lachrymal ducts and other ear, nose, throat and mouth structures are diagnosed and / or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air / gas flow studies, anatomic dimension studies and endoscopic studies. Access and occluding devices may be used to facilitate insertion of working devices such asendoscopes, wires, probes, needles, catheters, balloon catheters, dilation catheters, dilators, balloons, tissue cutting or remodeling devices, suction or irrigation devices, imaging devices, sizing devices, biopsy devices, image-guided devices containing sensors or transmitters, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting or delivering devices and implants, etc.

A deflectable and torqueable hollow guidewire device is disclosed for removing occlusive material and passing through occlusions, stenosis, thrombus, plaque, calcified material, and other materials in a body lumen, such as a coronary artery. The hollow guidewire generally comprises an elongate, tubular guidewire body that has an axial lumen. A mechanically moving core element is positioned at or near a distal end of the tubular guidewire body and extends through the axial lumen. Actuation of the core element (e.g., oscillation, reciprocation, and / or rotation) creates a passage through the occlusive or stenotic material in the body lumen.

A method and device for tissue removal. The device may be used to remove uterine fibroids and other abnormal gynecological tissue. According to one embodiment, the device includes a housing, an outer tube, and an inner tube. The outer tube is fixed to the housing and includes a side window proximate to its distal end. The side window may have sloped proximal and distal ends. The inner tube has a distal end positioned within the outer tube, the distal end being adapted to rotate and, at the same time, to move back and forth past the side window, with the rotational and translational movement of the inner tube being independently controllable. The distal end of the inner tube may have an external bevel. Suction is applied to the proximal end of the inner tube to draw tissue into the side window and to remove resected tissue through the inner tube.

Described herein are methods and systems for precisely placing and / or manipulating devices within the body by first positioning a guidewire or pullwire through the body from a first location, around a curved pathway, and out of the body through a second location, so that the distal and proximal ends of the guidewire extend from the body, then pulling a device into position using the guidewire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to the device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and / or manipulated within the body. Devices to modify tissue may also be positioned or manipulated so that a target tissue within the body is modified.

The invention is an oscillating, high speed burring instrument comprised of a handpiece, an elongate arthroscopic catheter extending distally from handpiece and terminating in a flexible or hinged portion which itself terminates with an oscillating burr. At least the distal portion of torsional drive shaft is radially flexible to accommodate the flexibility of the flexible or hinged portion of the catheter. A high speed oscillation of the burr is employed effective for cutting or abrading bone, which is typically oscillated at 10 kHz or higher. The burr is oscillated over a substantial arc, namely a majority portion of a full circle. The burr is not shielded in any manner and is fully exposed to the operational theater. The burr cuts or abrades bone or hard matter, while leaving softer tissues substantially or entirely undamaged.

A torsional dissection tip and method of use comprising a longitudinal-torsional resonator having a cutting surface at a distal end with cutting teeth of a pitch optimized to the torsional or longitudinal displacement of the distal tip. Utilization of the present art torsional dissection tip allows a surgeon to easily remove hard tissues such as bone without moving the present art instrument to any site except that which is to be dissected.

Disclosed herein is a new arthroscopic probe with a concave distal tip which simultaneously constrains and cuts tissue. It is particularly adapted to cutting ligaments and tendons. Also disclosed is a thermal energy delivery apparatus which includes (a) a probe means with a distal end and a proximal end, wherein the distal end has a concave tip; (b) a first electrode means positioned at the distal end of the probe means, wherein the first electrode means is configured to deliver sufficient thermal energy to cut ligaments or tendons; and (c) a cabling means coupled to the proximal end of the probe means. In another embodiment of the invention a controller for controlling the delivery of energy and liquid to a surgical instrument with a temperature sensor is disclosed. The energy is supplied by an energy source and the liquid is supplied by a pump. The controller includes a temperature and a flow regulator. The temperature regulator is coupled to the energy source and coupled to the pump. The temperature regulator is responsive to a first temperature indication from the temperature sensor to determine that the first temperature indication exceeds a setpoint and to reduce an energy level from the energy source. The flow regulator is coupled to the pump and coupled to the temperature regulator. The flow regulator includes responsiveness to the first temperature indication to increase a flow of the liquid from the pump.

Tools carry structures that are deployed inside bone and, when manipulated, cut cancellous bone to form a cavity.

Apparatus and method for the treatment of tissue, such as hard and soft tissues, wounds, tumors, muscles, and cartilage, through the direct contact of ultrasound energy is disclosed. Ultrasound energy is delivered to a target area through direct contact with an ultrasound tip. Ultrasound energy is also delivered through direct contact with a coupling medium. The ultrasound tip is specially designed to comprise of a cavity area for controlled fragmentation and the simultaneous sonication of a target area. The specially designed ultrasound tip allows for ultrasound energy to focus on a target area. The ultrasound apparatus may be moved in a variety of different directions during the treatment of tissue.

Disclosed is a surgical access device for providing at least one auxiliary lumen for the insertion of a surgical instrument or other therapeutic device into a patient's body. The device comprises a first working channel, a second working channel and at least one additional lumen for infusion of a distension media. The surgical access device comprises an outer diameter, and the ratio of the outer diameter to the inside diameter of the working channel is preferably less than about 2.25.

An elongate tubular body extends between a rotatable cutter and a control. The cutter is connected to the control with a rotatable element. A vacuum is applied through an annular passage defined between the tubular body and the rotatable element. The cutter has at least one radial projection which cooperates with at least one stationary element on the tubular body to cut material drawn into the tubular body. Material that has been processed by the cutter is aspirated through the tubular body for disposal.

Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Apparatus for resecting a diseased heart valve, the apparatus comprising: a body portion; a first handle and a second handle; a cutting blade; a set of retaining arms; a pass-off tool having a first attachment device configured to selectively engage the first handle attached to the body portion so as to allow placement of the second handle of the body portion adjacent to the diseased heart valve, and a controller tool having a second attachment device at the distal end thereof, the second attachment device configured to selectively engage the second handle attached to the body portion so as to allow positioning of the body portion adjacent to the diseased heart valve, a cutting blade actuator configured to cause the cutting blade to selectively rotate, and a retaining arm actuator configured to selectively position the set of retaining arms from the contracted state to the expanded state.

Disclosed is a tissue removal device. The device includes an outer tubular body, an inner tubular body and a cutting edge on the inner tubular body. The outer tubular body includes a window, which may be opened or closed by moving the cutting edge. The cutting edge has a hardness that exceeds the hardness of the material of the inner tube. The cutting edge may have a Rockwell C hardness of at least about 50, while the inner tube has a Rockwell C hardness of no more than about 40. The cutting edge may be formed by a milling step, and the inner tube may be formed by a drawing step. Tissue severed by the cutting edge may be removed at a rate of at least about 1.8 grams per minute through the inner tube, and the outer tubular body may have an outside diameter of no more than about 3.5 mm.

An apparatus for abrading tissue includes a bearing tube having distal and proximal ends, and a suction port formed distally in a sidewall of the bearing tube. An inner tube disposed within the bearing tube has a distal opening, the distal opening being located proximal of the suction port in the sidewall of the bearing tube. A solid transition region extending distally from the inner tube is disposed distal to the distal opening. An abrading element supported distally by the solid transition region is used to perform orthopedic abrading procedures. The outer diameter of the abrading element is greater than the inner diameter of the bearing tube. Debris generated by abrading procedures is aspirated through the suction port formed in the sidewall of the bearing tube and into the lumen of the inner tube. A hooded sheath extends distally from the bearing tube, or optionally from a sheath tube provided over the bearing tube.

A device is described that may be positioned at a location in an intervertebral disc for diagnosis or treatment of the disc. Treatment may include, for example, applying energy or removing material, and may decrease intradiscal pressure. Radiofrequency energy may be applied. A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus. Next the functional element is positioned at a selected location of the disc by advancing or retracting the catheter and optionally twisting the proximal end of the catheter. Then the functional unit treats the annular fissure. Optionally, there is an additional step of adding a substance to seal the fissure. An externally guidable intervertebral disc apparatus also is disclosed.

A method of increasing blood flow through an obstructed blood vessel includes providing an expandable member substantially made of a mesh having a plurality of interstices. The expandable member has a proximal member end and a distal member end spaced longitudinally apart by a tubular member body. The expandable member is substantially closed at the distal member end. The expandable member is inserted into the blood vessel. The expandable member is positioned within the blood vessel with the proximal member end upstream of the distal member end and the member body located radially adjacent at least a portion of an obstruction. The expandable member is expanded to bring at least a portion of the member body into contact with the obstruction. An outward radial force is exerted on the obstruction to dislodge at least one fragment from the obstruction and to enhance blood flow through the blood vessel past the obstruction. The at least one fragment is passed through at least one interstice of the member body in the radial direction. The at least one fragment is selectively retained within the expandable member. An apparatus for increasing blood flow through an obstructed blood vessel is also provided.

Device and methods for the treatment of wounds using ultrasound energy are disclosed. The portable wound treatment device may deliver ultrasound energy to a wound through direct contact with the ultrasound tip and / or through a liquid coupling medium. Several ultrasound tips specially designed to concentrate and focus ultrasound energy onto a wound are also disclosed. The ultrasound tip may also possess an abrasive peripheral boundary to aid in debriding the wound and / or removing necrotic tissue. The disclosed invention may have multiple beneficial effects in treating a wound such as sterilizing a wound, reducing external bleeding, and / or providing pain relief.

A method and device for tissue removal. The device may be used to remove uterine fibroids and other abnormal gynecological tissue. According to one embodiment, the device includes a housing, an outer tube, and an inner tube. The outer tube is fixed to the housing and includes a side window proximate to its distal end. The side window may have sloped proximal and distal ends. The inner tube has a distal end positioned within the outer tube, the distal end being adapted to rotate and, at the same time, to move back and forth past the side window, with the rotational and translational movement of the inner tube being independently controllable. The distal end of the inner tube may have an external bevel. Suction is applied to the proximal end of the inner tube to draw tissue into the side window and to remove resected tissue through the inner tube.