Rotary tissue cutting device

Abstract

To provide a novel rotational tissue cutting device.SOLUTION: Disclosed embodiments include apparatuses, systems and methods for cutting an opening in a tissue wall. An apparatus includes an inner cutting member having a first cylindrical body supporting at least one first cutting surface at a distal end. The first cutting surface faces in a first rotational direction relative to an axis of the first cylindrical body and has a first cutting edge at an outer periphery of the first cylindrical body. The apparatus also includes an outer cutting member having a second cylindrical body concentrically disposed around the first cylindrical body, and supporting at least one second cutting surface at the distal end. The second cutting surface faces in a second rotational direction relative to the axis and has a second cutting edge at an inner periphery of the second cylindrical body. A tissue is rotatably scissorable between the first cutting edge of the inner cutting member and the second cutting edge of the outer cutting member in response to applying the distal end of the apparatus to a tissue and counter-rotating the inner cutting member and the outer cutting member.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] [Cross - Reference to Related Applications] This application is related to the co - pending application, Attorney Docket No. ORA0107US1, "ROTATIONAL TISSUE CUTTING CONTROL DEVICE," filed herein, the content of which is hereby incorporated by reference in its entirety.

[0002] The present disclosure relates to devices, systems, and methods for cutting an opening in a tissue wall.

Background Art

[0003] The description in this section merely provides background information related to the present disclosure and may not constitute prior art.

[0004] The ability to access tissue within a patient's body without performing invasive surgery enables types of analysis, diagnosis, and treatment that are accompanied by continuous improvements, including reduced pain, shorter recovery times, and lower risk of complications. As two examples, endoscopic imaging and catheterization procedures have enabled the diagnosis and treatment of numerous internal lesions without performing invasive surgery.

[0005] In some cases, it may be desirable to insert a thin probe - like device to remotely cut tissue within a patient's body. For example, to provide pain relief to a patient when the bile duct is blocked, it is desirable to insert a probe into the gastrointestinal tract to cut an opening and enable the gallbladder to release bile into the duodenum, thereby relieving the painful swelling of the gallbladder. However, it may be found that even though the probe can reach the desired position, it is very difficult to remotely perform a small cut. If there is no structure to push the tissue in the opposite direction behind during cutting, the tissue may be too flexible to pierce or cut.

Summary of the Invention

Means for Solving the Problem

[0006] The disclosed embodiments include an apparatus, a system, and a method for cutting an opening in a tissue wall.

[0007] In an exemplary embodiment, the apparatus includes an inner cutting member having a first cylindrical body that supports at least one first cutting surface at a distal end. The first cutting surface faces in a first rotational direction with respect to the axis of the first cylindrical body and has a first cutting edge at the outer periphery of the first cylindrical body. The apparatus also includes an outer cutting member that is concentrically disposed around the first cylindrical body and has a second cylindrical body that supports at least one second cutting surface at a distal end. The second cutting surface faces in a second rotational direction with respect to the axis and has a second cutting edge at the inner periphery of the second cylindrical body. The tissue is rotatably cuttable between the first cutting edge of the inner cutting member and the second cutting edge of the outer cutting member in response to application of the distal end of the apparatus to the tissue and reverse rotation of the inner and outer cutting members.

[0008] In another exemplary embodiment, the apparatus includes an inner cutting member having a first cylindrical body that supports two or more first cutting surfaces at a distal end of the apparatus. The first cutting surfaces face in a first rotational direction with respect to the axis of the first cylindrical body. The first cutting surfaces are present at the outer periphery of the first cylindrical body and include a first cutting edge that is inclined with respect to the axis of the inner cutting member. The first cutting surfaces also include an anchor tip that extends outwardly beyond the distal end and is configured to penetrate the tissue. The apparatus also includes an outer cutting member that is concentrically disposed around the first cylindrical body and has a second cylindrical body that supports at least one second cutting surface at a distal end of the apparatus. The second cutting surface faces in a second rotational direction with respect to the axis and has a second cutting edge at the inner periphery of the second cylindrical body. The tissue is penetrable by the anchor tip and is rotatably cuttable between the first cutting edge of the inner cutting member and the second cutting edge of the outer cutting member in response to application of the distal end of the apparatus to the tissue and reverse rotation of the inner and outer cutting members.

[0009] In a further exemplary embodiment, the method includes extending a cylindrical cutting device having an inner cutting member and a concentric outer cutting member for the tissue. The inner cutting member and the concentric outer cutting member have opposing cutting surfaces configured to radially cut the tissue orthogonal to the axes of the inner cutting member and the concentric outer cutting member. The inner cutting member moves to penetrate the tissue at the anchor tip at the distal end of the inner cutting member. The inner cutting member and the concentric outer cutting member rotate relative to each other to radially cut the tissue.

[0010] In another exemplary embodiment, an apparatus for controlling a reversibly rotatable cutting device includes a first radial actuator configured to engage a first drive shaft. A second radial actuator is configured to engage a second drive shaft, the second drive shaft being coaxially disposed with the first drive shaft. The housing supports the first radial actuator and the second radial actuator and allows the first drive shaft and the second drive shaft to extend therethrough, the first drive shaft and the second drive shaft being relatively reversibly rotatable in response to rotation of at least one of the first radial actuator and the second radial actuator.

[0011] In a further exemplary embodiment, the device for controlling the reversibly rotatable cutting device includes a first radial actuator configured to engage a first drive shaft. A second radial actuator is configured to engage a second drive shaft, which is arranged coaxially with the first drive shaft. The reverse rotation mechanism mechanically couples the first radial actuator and the second radial actuator, and is configured to rotate the second radial actuator in a second direction when the first radial actuator rotates in a first direction. The housing supports the first radial actuator and the second radial actuator and allows the first drive shaft and the second drive shaft to extend therethrough. The rotation control device is mechanically coupled to the first radial actuator to enable rotation of the first radial actuator and to enable the first drive shaft and the second drive shaft to rotate reversibly simultaneously in response to rotation of the first rotation control device.

[0012] In yet another exemplary embodiment, a system for cutting an opening in a tissue wall includes a drive shaft assembly including a first drive shaft, a second drive shaft coaxially disposed about the first drive shaft and configured to rotate independently of the first drive shaft, and a sheath housing the first drive shaft and the second drive shaft. A first radial actuator is configured to engage the first drive shaft. A second radial actuator is configured to engage the second drive shaft. A housing supports the first radial actuator and the second radial actuator and allows the sheath housing the first drive shaft and the second drive shaft to extend therethrough. A rotation control device is mechanically coupled to the first radial actuator to allow rotation of the first radial actuator relative to the second radial actuator. A cutting device includes an inner cutting member having a first cylindrical body supporting at least one first cutting surface at a distal end of a cutter, the inner cutting member being mechanically coupled to the first drive shaft, the first cutting surface facing in a first rotational direction relative to an axis of the first cylindrical body and having a first cutting end at an outer periphery of the first cylindrical body. An outer cutting member having a second cylindrical body is concentrically disposed about the first cylindrical body and is mechanically coupled to the second drive shaft, the outer cutting member supporting at least one second cutting surface at a distal end of the device, the second cutting surface facing in a second rotational direction relative to the axis and having a second cutting end at an inner periphery of the second cylindrical body. The tissue is rotatably cuttable between a first cutting edge of the inner cutting member and a second cutting edge of the outer cutting member in response to application of the distal end of the device and rotation of the rotation control device.

[0013] Further features, advantages, and areas of applicability will become apparent from the description provided herein. It is to be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.

[0014] The drawings described in this specification are for illustrative purposes only and are not intended to limit the scope of the present disclosure in any way. The components in the drawings are not necessarily to scale, and emphasis is placed on illustrating the principles of the disclosed embodiments.

Brief Description of the Drawings

[0015]

Figure 1

Figure 2

Figure 3A

Figure 3B

Figure 3C

Figure 4A

Figure 4B

Figure 4C

Figure 5A

Figure 5B

Figure 5C

Figure 6

Figure 7

Figure 8

Figure 9

Figure 10

Figure 11

Figure 12

[0016] The following description is merely exemplary in nature and is not intended to limit the present disclosure, application, or uses. It will be noted that the first digit of the three-digit reference numbers and the first two digits of the four-digit reference numbers correspond respectively to the first digit of the one-digit figure number and the first two digits of the figure number in which the element first appears.

[0017] The following description, without limitation, is merely exemplary and describes various embodiments of an apparatus, system, and method for cutting tissue. As described in detail below, a cutting device having reversibly rotatable rotating elements extends into the tissue and causes rotation relative to each other to cut through the tissue.

[0018] Referring to FIG. 1, an exemplary system 100 is provided for cutting an opening in a tissue wall of a patient's anatomical region (not shown in FIG. 1). In various embodiments, system 100 generally includes a cutting device 111, a control device 150 for controlling the cutting device 111, and a drive shaft assembly 140 for coupling the cutting device 111 to the control device 150. As will be described in detail below, the cutting device 111 is a reversibly rotatable cutting device having a cutting member configured to rotate in directions 103 or 105 about axis 101, as will be further described below with reference to FIGS. 2, 3A-3C, 4A-4C, 5A-5C, and 6. The drive shaft assembly 140 includes a first drive shaft and a second drive shaft, and the second drive shaft includes a hollow shaft coaxially disposed around the first drive shaft in some embodiments. The first drive shaft and the second drive shaft are connectable to members of the cutting device 111 and are housed within an enclosure. In some embodiments, the first drive shaft and the second drive shaft include flexible, reversibly rotatable cables. The control device 150 includes a housing 160 that supports a position adjustment device 170 and at least one rotary grip 180, each of which will be further described below with reference to FIGS. 7, 8, and / or 9.

[0019] Referring to FIG. 2, the cutting device 111 includes two reversibly rotatable members, an inner cutting member 211 and an outer cutting member 251. As will be further described below with reference to FIGS. 3A-3C and 5A-5C, the inner cutting member 211 is configured to penetrate and / or secure tissue at a distal end 290 in the cutting device 211, and then draw the tissue into a cutting region 292 between opposing cutting surfaces between an inner cutting surface 241 in the inner cutting member 211 and an outer cutting surface 271 in the outer cutting member 251. Thus, rotation of the inner cutting member 211 and the outer cutting member 251 shears the tissue and forms an opening in the tissue.

[0020] Referring to FIGS. 3A - 3C, the inner cutting member 211 includes a body 315 having a proximal end portion 349 that engages a drive shaft assembly 140 (FIG. 1, not shown in FIGS. 3A - 3C) which will be further described below in connection with FIG. 11. The inner cutting member 211 includes one or more anchor tip portions 321 that extend longitudinally toward the distal end portion 290 and are radially curved in direction 103 about axis 101. The anchor tip portions 321 are angled so as to extend toward the distal end portion 290 in front of one or more inner cutting surfaces 241. The anchor tip portions 321 have penetration end portions 323 configured to penetrate a tissue wall (not shown in FIGS. 3A - 3C) present at the distal end portion 290 of the inner cutting member 211. In some embodiments, as shown in FIGS. 2, 3A - 3C, and 6, the anchor tip portions 321 depict a helical shape. In some other embodiments, the anchor tip portions 321 may also include a flat fixation surface 325 that faces away from the distal end portion 290.

[0021] The inner cutting member 211 also includes one or more inner cutting surfaces 241. The inner cutting surfaces 241 are inclined from a leading cutting edge portion 343 to a trailing cutting edge portion 345. In some embodiments, the leading cutting edge portion 343 of the inner cutting surface 241 is at the outer edge of the inner cutting member that engages the leading edge of the outer cutting surface 271 of the outer cutting member 251, as will be further described below. In some embodiments, the one or more inner cutting surfaces 241 are inclined at an acute angle with respect to axis 101. The one or more inner cutting surfaces 241 are very angled such that in the cutting region 292 (FIG. 2), the one or more inner cutting surfaces 241 of the inner cutting member and the one or more inner cutting surfaces 271 of the outer cutting member 251 meet at an acute angle facing the distal end portion 290 like the opposing blades of a pair of scissors, thereby facilitating the excision of tissue. The inner cutting surface 241 of the inner cutting member 211 is parabolic in shape and terminates at a lower end portion 347, serving to form a scissor shape between the inner cutting surface 241 and the outer cutting surface 271.

[0022] Continuing to refer to FIGS. 3A - 3C, by positioning the anchor tip 321 against the tissue wall and rotating the inner cutting member 211 in direction 103 about axis 101, the penetration end 323 of the anchor tip portion 321 can penetrate the tissue. The continuous rotation in direction 103 about axis 101 can cause the flattened fixation surface 325 to pull away from the tissue wall from the distal end 290 and into the cutting region 292. In the cutting region, the inner cutting surface 241 shears the tissue against the outer cutting surface 271 (FIG. 2), as described above and further described below in connection with FIG. 6.

[0023] Referring to FIGS. 4A - 4C, the outer cutting member 251 includes a body 455 having a proximal end 499 that engages a drive shaft assembly 140 (FIG. 1, not shown in FIGS. 4A - 4C), which is further described below in connection with FIG. 11. The outer cutting member 251 includes a leading edge portion 461 that, in some embodiments, includes a pointed end 463 that extends longitudinally toward the distal end 290. In some embodiments, the leading edge portion 461 is angled away from the pointed end 463 at the distal end 290 and promotes penetration into the tissue wall, as further described below in connection with FIG. 6. The outer cutting member 251 also includes one or more outer cutting surfaces 271. The outer cutting surface 271 is inclined from a leading cutting edge 473 to a trailing cutting edge 475. In some embodiments, the leading cutting edge 473 of the outer cutting surface 271 is at the inner edge of the outer cutting member 251 and engages the leading edge 343 of the inner cutting surface 241 of the inner cutting member 221, as further described below in connection with FIG. 6.

[0024] In some embodiments, the outer cutting surface 271 of the outer cutting member 251 is generally U-shaped and terminates at the lower end 477. As shown in FIGS. 4A-4C, in some embodiments, the outer cutting surface 271 is substantially parallel to the axis 101. With respect to the tissue wall, the outer cutting member 251 is positioned along the inner cutting member (FIGS. 2 and 3A-3C), and with respect to the inner cutting member 211, the outer cutting member 251 is rotated counterclockwise around the axis 101 in the second direction 105, such that, as further described below in connection with FIG. 6, tissue between the outer cutting surface 271 of the outer cutting member 251 and the inner cutting surface 241 of the inner cutting member 211 can be excised.

[0025] In some embodiments, as shown in FIGS. 3A-3C and FIGS. 4A-4C, the inner cutting surface 241 is angled acutely with respect to the axis 101, the outer cutting surface 271 is substantially parallel to the axis 101, and opposing cutting surfaces are provided that intersect at an acute angle so as to facilitate excision of tissue. However, by disposing the inner cutting surface 241 of the inner cutting member 211 substantially parallel to the axis 101, an identical acute angle can be formed between the opposing cutting surfaces, while, on the other hand, the outer cutting surface 271 is angled acutely with respect to the axis 101 such that an acute cutting angle is formed between the cutting surfaces 241 and 271. Further, in some other embodiments, both the inner cutting surface 214 of the inner cutting member 211 and the outer cutting surface 271 of the outer cutting member 251 are angled from the axis 101 in -opposing directions- such that an acute cutting angle can be formed between the opposing cutting surfaces 241 and 271. Similarly, as previously described in connection with FIGS. 3A-3C and 4A-4C, the leading edge 343 of the inner cutting surface 241 of the inner cutting member 221 is on the outer surface of the inner cutting member 221, and the leading edge 473 of the outer cutting surface 471 of the outer cutting member 251 is on the inner surface of the outer cutting member 251, such that the leading edges 343 and 473 come together like the leading edges of scissors blades and facilitate excision of tissue therebetween.

[0026] Referring to FIGS. 5A-5C, in some embodiments, the inner cutting member 511 includes a body 515 having a proximal end 549 that engages a drive shaft assembly 140 (FIG. 1, not shown in FIGS. 3A-3C) that will be further described below in connection with FIG. 10. Instead of the angled anchor tip 321 of the inner cutting member 211 as shown in FIGS. 2 and 3A-3C, the inner cutting member 511 includes a recessed anchor tip 521 having a pair of through ends 523 at one end. The through ends 523 are configured to penetrate a tissue wall (not shown in FIGS. 5A-5C) present at the distal end 290 of the inner cutting member 511. The anchor tip 521 can thus hold tissue when the outer cutting member 251 rotates in the opposite direction relative to the inner cutting member 511. The inner cutting member 511 and the outer cutting member (not shown) can then rotate relative to each other to shear and cut the tissue between the inner cutting surfaces. In some embodiments, the inner cutting surface 541, which includes a generally parabolic shape that terminates at a leading edge 543, a trailing edge 545, and a lower end 547, is equivalent to the generally parabolic shape that terminates at a leading edge 343, a trailing edge 345, and a lower end 347 of the inner cutting member 211, as shown in FIGS. 2 and 3A-3C. However, it should be noted that the inner cutting surface 541 is angled differently relative to the axis 101 corresponding to the angle of the outer cutting surface 271, as previously described in connection with FIGS. 4A-4C, and can form a shearing shape between the inner cutting surface 541 and the outer cutting surface 271.

[0027] In various embodiments, referring to FIG. 6, a cutting device 111 that includes an inner cutting member 211 and an outer cutting member 251 is positioned and operated to penetrate and cut tissue. The cutting device 111 is positioned against a tissue wall 601 represented by a dashed line. The inner cutting member 211 and the outer cutting member 251 rotate relative to each other in a counter-rotating manner in a first direction 130 around an axis 101, and the outer cutting member 251 also rotates relative to each other while counter-rotating in a second direction 105 around the axis 101. Rotation of the inner cutting member 321 in the first direction 103 causes the piercing end 323 of the anchor tip 321 to penetrate the tissue wall 601. By further rotating the inner cutting member 211 relative to each other, a flat fixed surface 325 facing away from the distal end 290 of the cutting device 111 draws the tissue into the cutting region 292 at a direction 607 in the tissue wall 601.

[0028] When the cutting members 211 and 251 of the cutting device 111 move relative to each other, the tissue wall 601 is drawn between the inner cutting surface 241 of the inner cutting member 211 and the outer cutting surface 271 of the outer cutting member 251. When the inner cutting member 211 and the outer cutting member 251 rotate relative to each other around the axis 101, the inner cutting surface 241 and the outer cutting surface 271 shear and cut the tissue 601 around the periphery of the cutting device 111 to form an opening in the tissue wall 601.

[0029] In some other embodiments, including a cutting device 111 such as an inner cutting member 511 as shown in FIGS. 5A - 5C, the anchor tip 521 of the inner cutting member 511 may not be configured to draw the tissue into the cutting region between it and the cutting surface, similar to the anchor tip 221 of the inner cutting member 211 (FIGS. 2, 3A - 3C, and 6). However, the pressure applied by the cutting device 111 towards the distal end 290 of the cutting device 111 against the tissue wall 601 results in piercing of the tissue wall 601 by the cutting device 111 and movement of the cutting device 111 into the tissue wall, and can carry the tissue into the cutting region 292 between the inner cutting surface 541 of the inner cutting member 511 and the outer cutting surface 271 of the outer cutting member 251.

[0030] Referring to FIG. 7, in various embodiments, the control device 150 includes components that can be used to position and relatively rotate a cutting device 111 (not shown in FIG. 7). The position adjustment device 170 includes a sleeve 772 that is fixedly joined to be fixed to a sheath of a drive shaft assembly 140 (not shown in FIG. 7), and subsequently the drive shaft assembly extends from a first end 779 of the sleeve 772 facing in the direction in which the cutting device 111 is disposed. The sleeve 772 is slidably receivable into a first end 774 of the housing 160 of the control device 150. The sleeve 772 includes a locking groove 777 for receiving a sheath lock 776, and is then received via a sheath lock port 778 in the housing 160.

[0031] As shown in FIG. 7, in some embodiments, the sheath lock 776 is in the form of a serrated lock screw that mechanically and selectively engages a locking groove 777 within the sleeve 772. Rotating the sheath lock 776 can loosen the sheath lock 776 from the locking groove 777, enabling movement of the sleeve 772 and thus the drive shaft assembly 140. The sleeve 772 is operated by sliding the sleeve 772 relative to the housing 160. Next, once the cutting device 111 is disposed at a desired position, the sheath lock 776 rotates to engage the sheath lock 776 within the locking groove 777 of the sleeve 772, locking the drive shaft assembly 140, and thus enabling the cutting device 111 (likewise, not shown in FIG. 7) to be coupled with the drive shaft assembly 140 at the desired position. It should be understood that other forms of the position adjustment device 170 may be used, such as including a lever or latch for locking the sleeve 772 in a predetermined position. It should also be understood that other forms of the position adjustment device 170 may be fixedly coupled to a housing of a bronchoscope or to a housing of other devices used to direct the cutting device 111, such that movement of the housing results in movement of the drive shaft assembly 140. Embodiments of the present disclosure are not limited to the use of any particular form of the position adjustment device 170.

[0032] Referring further to FIG. 7, in some embodiments, the rotary gripping portion 180 may include a user gripping portion 781, such as a serrated gripping portion, and an interface 782 used to engage a rotary mechanism, as described below in connection with FIG. 8.

[0033] Referring to FIG. 8, in some embodiments, the control device 150 includes a reverse rotation mechanism 802. The reverse rotation mechanism 802 includes a first radial actuator 812 configured to engage a first drive shaft (not shown in FIG. 8) of the drive shaft assembly 140, which may in turn be coupled to an inner cutting member 211 of the cutting device 111 (both not shown in FIG. 8). The reverse rotation mechanism 802 includes a second radial actuator 852 configured to engage a second drive shaft (not shown in FIG. 8) of the drive shaft assembly 140, which may in turn be coupled to an outer cutting member 251 of the cutting device 111. The configuration of the drive shaft assembly 140 is further described below in connection with FIG. 11.

[0034] To reverse-rotate the drive shaft of the drive shaft assembly 140, the first radial actuator 812 and the second radial actuator 852 are mechanically coupled so that when one or the other rotates, the radial actuators 812 and 852 are rotated in opposite directions. In the reverse-rotation mechanism 802 shown in FIG. 8, the first radial actuator 812 includes a first bevel gear 814 facing the first end 801 of the housing 160, and the second radial actuator 852 includes a second bevel gear 854 facing away from the first end 801 of the housing 160. Mechanically coupled to each of the first bevel gear 814 and the second bevel gear 854 is a transmission gear 892 that includes a differential bevel gear 894. Rotation of the first bevel gear 814 imparts rotation to the differential bevel gear 894, which causes rotation opposite to that of the second bevel gear 854. The reverse-rotation mechanism 802 may also include a chassis 896 for supporting the differential actuators 812 and 854, as well as the transmission gear 892. As shown in FIG. 8, the first differential actuator 812 receives an interface 782 on the rotary grip portion 180 such that when the rotary grip portion 180 rotates in one direction, the first differential actuator 812 rotates in the same direction and the second differential actuator 852 rotates in the opposite direction. As a result, the drive shaft of the drive shaft assembly 140 rotates relatively in reverse, reversing the cutting members 211 and 251 of the cutting device 111.

[0035] Referring to FIG. 9, another embodiment of the reverse rotation mechanism 902 for promoting reverse rotation of the drive shaft of the drive shaft assembly 140 and the cutting device 111 (both not shown in FIG. 9) uses spur gears instead of the bevel gears as used in the reverse rotation mechanism 802 of FIG. 8. The reverse rotation mechanism 902 includes a base gear 914 coupled to a first radial actuator 812 (not shown in FIG. 9) such that when the first radial actuator 812 rotates, as described in connection with FIG. 8, the base gear 914 is imparted with rotation. The base gear 914 is an inward spur gear configured to rotate about the axis 101. The base gear 914 engages with a shaft 992. The shaft 992 includes a first transmission gear 915 which may include an outward spur gear. The base gear 914 engages with the first transmission gear 915 to impart rotation to the first transmission gear 915 in the same direction as the rotation of the base gear 914, such as the direction 103 shown in FIG. 9. The first radial actuator 812, the base gear 914, or the shaft 992 may be coupled to one of the first drive shaft or the second drive shaft (not shown in FIG. 9) to impart rotation to the first drive shaft.

[0036] The shaft 992 may also include a first shaft 907 that extends to a second transmission gear 919, which may likewise include an external spur gear. The first shaft 907 may be rotatably mounted within a cradle (not shown in FIG. 9) along with the other elements shown in FIG. 9. Both the first shaft 907 and the second transmission gear 919 rotate in the same direction as the first transmission gear 915. The second transmission gear 919 engages a reverse rotation gear 954 that may be rotatably mounted within a cradle (not shown in FIG. 9). The engagement of the reverse rotation gear 954 with the second transmission gear 919 rotates the reverse rotation gear 954 in a direction opposite to that of the second transmission gear 919 of the shaft 992. Thus, for example, if the base gear 914 rotates in direction 103, the reverse rotation gear 954 may rotate in direction 105. The reverse rotation gear 954 may be connected to a second shaft 957, which may be connected to a second drive shaft (if the first drive shaft is connected to the first radial actuator 812 or the base gear 914), or may be connected to the first drive shaft (if the second drive shaft is connected to the first radial actuator 812 or the base gear 914). In either case, the rotation of the first radial actuator 812 and the base gear 914 in the first direction may result in the reverse rotation of the reverse rotation gear 954, imparting reverse rotation to a cutting member (not shown in FIG. 9) of the cutting device.

[0037] It should be understood that the reverse rotation mechanism 902 may include a gear differential that allows the base gear 914 to rotate at a different angular velocity from the reverse rotation gear 954. For example, the radius of the base gear 914 and the multiple spurs extending therefrom, and the radius of the first transmission gear 915 and the multiple spurs extending therefrom, change the rotational speed of the shaft 992 relative to the base gear 914. Alternatively or additionally, the radius of the reverse rotation gear 954 and the multiple spurs extending therefrom, and the radius of the second transmission gear 919 and the multiple spurs extending therefrom, change the reverse rotation speed of the reverse rotation gear 954 relative to the second transmission gear 919. As a result, the drive shaft (not shown in FIG. 9) may reverse rotate at different speeds, causing the cutting members of the cutting device (likewise not shown in FIG. 9) to reverse rotate at different speeds. Similarly, while FIG. 9 only shows spurs that partially extend around the peripheral length of the spur gear to emphasize the interengagement of the spurs and the associated spur gear, it should be understood that the spurs may extend completely around the peripheral length of the spur gear.

[0038] Referring to FIG. 10, in some other embodiments, the control mechanism 950 includes a housing 160 and a position adjustment device 170 such as a control device as shown in FIGS. 7 and 8. However, unlike the control device 150, the control device 1050 includes two rotary gripping parts 1082 and 1084. Each of the rotary gripping parts is separately connected to the drive shaft of the drive shaft assembly 140 and can affect the individual rotations of the associated cutting members 211 and 251 of the cutting device 111 (not shown in FIG. 10). Each of the rotary gripping parts 1082 and 1084 can be rotated separately, for example, by rotating the first rotary gripping part 1082 in the first direction 1083 and rotating the second rotary gripping part 1084 in the second direction 1085, to selectively enable the rotation of the drive shaft of the drive shaft assembly 140 and the individual rotations of the associated cutting members 211 and 251 of the cutting device 111, or to enable the simultaneous reverse rotation of the associated cutting members 211 and 251 of the cutting device 111.

[0039] Referring to FIG. 11, in various embodiments, the drive shaft assembly 140 includes a first drive shaft 1142 that can be connected to an inner cutting member 211 (not shown in FIG. 10) of the cutting device 111. The drive shaft assembly 140 also includes a second drive shaft 1144 that can be connected to an outer cutting member 251 of the cutting device 111. The first drive shaft 1142 may be solid or hollow, and the second drive shaft 1144 is a hollow member coaxially disposed around the first drive shaft 1142. The first drive shaft 1142 and the second drive shaft 1144 are disposed within a sheath 1146 that can be fixedly connected to a sleeve 772 (FIGS. 7 and 8) so as to enable the extension and retraction of the drive shaft assembly 140. The first drive shaft 1142 may be separated from the second drive shaft 1144 by a gap 1148 so as not to interfere with the rotation of the first drive shaft 1142. Similarly, the second drive shaft 1144 may be separated from the sheath 1146 by a gap 1148 so as not to interfere with the rotation of the second drive shaft 1144 by the outer sheath 1146.

[0040] Referring to FIG. 12, an exemplary method 1200 for tissue cutting is provided. The method 1200 starts at block 1205. At block 1210, a cylindrical cutting device having an inner cutting member and a concentric outer cutting member extends relative to the tissue. The inner cutting member and the concentric outer cutting member have opposing cutting surfaces configured to radially cut the tissue orthogonal to the axis of the inner cutting member and the concentric outer cutting member. The configuration and positioning of the cutting members have been described above in connection with FIGS. 2, 3A - 3C, 4A - 4C, 5A - 5C, and 6.

[0041] At block 1220, as described above in connection with FIGS. 3A - 3C, 5A - 5C, and 6, the inner cutting member moves to penetrate the tissue at an anchor tip at the distal end of the inner cutting member. At block 1230, as described above in connection with FIG. 6, the inner cutting member and the concentric outer cutting member rotate relative to each other to radially cut the tissue. The method 1200 ends at block 1235.

[0042] The description of the invention of the cutting device and the control device, and the systems and methods described herein as being used to cut holes in tissue walls may be used to cut tissue in different parts of the body and may be guided by an endoscope, bronchoscope, laparoscope, or other device, as will be understood.

[0043] The embodiments for carrying out the invention shown above are essentially merely illustrative, and it will be understood that variations that do not depart from the gist and / or spirit of the subject matter according to the claims are intended to be within the scope of the claims. Such variations are not regarded as departing from the spirit and scope of the subject matter according to the claims.

Description of Reference Numerals

[0044] 100 System 101 Axis 103 First Direction 105 Second Direction 111 Cutting Device 130 First Direction 140 Drive Shaft Assembly 150 Control Device 160 Housing 170 Position Adjustment Device 180 Rotary Grip Portion 211 Cutting Member 214 Inner Cutting Surface 221 Inner Cutting Member 241 Inner Cutting Surface 251 Outer Cutting Member 271 Outer Cutting Surface 290 Distal End 292 Cutting Region 315 Body 321 Anchor Tip 323 Penetrating End 325 Fixed Surface 343 Leading Cutting Edge 345 Following Cutting Edge 347 Lower End 349 Proximal End 455 Body 461 Leading Edge 463 End 471 Outer cutting surface 473 Leading cutting edge part 475 Subsequent cutting edge part 477 Lower end 499 Proximal end 511 Inner cutting member 515 Body 521 Anchor tip 523 Through end 541 Inner cutting surface 543 Leading edge 545 Subsequent edge 547 Lower end 549 Proximal end 601 Tissue 772 Sleeve 774 First end 776 Sheath lock 777 Lock groove 778 Sheath lock port 779 First end 781 User grip part 782 Interface 801 First end 802 Reverse rotation mechanism 812 First differential actuator 814 Gear 852 Second differential actuator 854 Gear 892 Transmission gear 894 Gear 896 Chassis 902 Reverse rotation mechanism 907 First shaft 914 Base gear 915 First transmission gear 919 Second transmission gear 950 Control mechanism 954 Reverse rotation gear 957 Second shaft 992 Shaft 1050 Control device 1082 First rotary grip part 1083 First direction 1084 Second rotation gripping part 1085 Second direction 1142 First drive shaft 1144 Second drive shaft 1146 Sheath 1148 Gap

Claims

1. An apparatus comprising a cutting device having a distal end positionable adjacent to a tissue wall, wherein the cutting device is a first cutting member having a penetrating tip portion that curves and extends circumferentially around a longitudinal axis, the penetrating tip portion forming at least a portion of the distal end, a first cutting surface located proximal to the penetrating tip portion, the penetrating tip portion extending distally at a predetermined angle with respect to the longitudinal axis of the apparatus distal to the first cutting surface, the penetrating tip portion being configured to pierce tissue of the tissue wall, and being a part of an anchor tip portion configured to draw the tissue from the tissue wall toward the first cutting surface and having a flat surface facing away from the distal end; a second cutting member mounted concentrically and rotatable in the opposite direction with respect to the first cutting member, the second cutting member having a second cutting surface disposed on the opposite side of the first cutting surface; and characterized by including the above.

2. The first cutting member includes a cylindrical body, the cylindrical body includes a distal end having a gap at least partially formed by the penetrating tip portion, and the apparatus according to claim 1, characterized in that the distal end with the gap is configured to receive the tissue at the distal end.

3. The apparatus according to claim 1, characterized in that the penetrating tip portion includes a concave cutting surface facing the distal end and terminating in a sharp penetrating tip portion.

4. The apparatus according to claim 3, characterized in that the penetrating tip portion and the first cutting surface form a substantially helical shape.

5. The apparatus according to claim 1, characterized in that the penetrating tip portion includes a flat fixed surface configured to draw the tissue from the tissue wall toward the first cutting surface.

6. The apparatus according to claim 1, characterized in that the first cutting member and the second cutting member are coaxially arranged such that the reverse rotation of the first cutting member and the second cutting member sandwiches the tissue to create a hole in the tissue wall.

7. The device according to claim 1, characterized in that at least one of the first cutting surface and the second cutting surface is inclined with respect to the axes of the inner cutting member and the outer cutting member.

8. The first cutting surface is inclined at an acute angle with respect to the axis, The device according to claim 7, characterized in that the second cutting surface is substantially parallel to the axis.

9. The first cutting member includes a plurality of first cutting surfaces, The device according to claim 1, characterized in that the second cutting member includes a plurality of second cutting surfaces.

10. The device according to any one of claims 1 to 9, characterized in that the proximal end of the cutting device is configured to be connected to a drive mechanism configured to relatively rotate the first cutting member and the second cutting member in opposite directions.

11. The device according to claim 10, characterized in that the drive mechanism is configured to rotate the first cutting member in a first direction and to rotate the second cutting member in a second direction.

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