45 results about "Carpal ligament" patented technology

A system, method and / or apparatus is provided for visualization or imaging of the transverse carpal ligament and surrounding structures / features of a hand of a patient, and treatment of the transverse carpal ligament, particularly, but not necessarily, for performing non-invasive carpal tunnel release. The subject invention utilizes ultrasound waves preferably, but not necessarily, in the high frequency range and cavitations to image the transverse carpal ligament (TCL), record its location in three-dimensional space, and perform precision treatment on the transverse carpal ligament. Treatment may range from stretching or lengthening the TCL to complete tissue ablation or dissection of a portion or portions of the TCL (as is performed in a standard carpal tunnel release procedure) in order to release pressure within the carpal tunnel. Particularly, high temperature conditions are generated at target tissue of the TCL resulting in elongation or necrosis / dissection. The subject system, apparatus and / or method provides the surgeon to relieve a patient of carpal tunnel syndrome symptoms in a bloodless, efficient, and accurate manner.

Described herein are methods, systems, and devices for performing a minimally invasive carpal tunnel release procedure to cut a target transverse carpal ligament. In some embodiments, the method may include the steps of advancing a probe percutaneously though a patient's skin from a first location, advancing a tissue modification device from the first location and between the target ligament and non-target tissue so that a proximal handle on the tissue modification device extends from the patient at the first location, attaching a distal handle in communication with the distal end of the tissue modification device. In some embodiments, a system may include a probe configured to be advanced percutaneously though a patient's skin from a first location, a tissue modification device comprising a proximal handle and a flexible distal region having uni-directional blades, and a distal handle configured to connect to the distal end of the tissue modification device.

Instruments for use in minimally invasive carpal tunnel release include a cannula and a cutting member movable longitudinally within the cannula to advance a cutting blade of the cutting member along a longitudinal slot in the cannula to sever a transverse carpal ligament disposed over the slot. A dilating member is provided for creating a subligamentous space to accommodate the cannula and / or for removing adhered synovium from a lower surface of the ligament. A method for minimally invasive carpal tunnel release involves establishing a subcutaneous pathway to the carpal tunnel from an incision in the forearm, introducing the cannula in the carpal tunnel via the pathway, and severing the transverse carpal ligament with the cutting blade of the cutting member, all of which steps are performed under direct endoscopic visualization.

Instruments for use in minimally invasive carpal tunnel release include a cannula and a cutting member movable longitudinally within the cannula to advance a cutting blade of the cutting member along a longitudinal slot in the cannula to sever a transverse carpal ligament disposed over the slot. A dilating member is provided for creating a subligamentous space to accommodate the cannula and / or for removing adhered synovium from a lower surface of the ligament. A method for minimally invasive carpal tunnel release involves establishing a proximal entry into the carpal tunnel from an incision in the volar aspect of the forearm, introducing the cannula in the carpal tunnel via the incision, and severing the transverse carpal ligament from proximal to distal with the cutting blade of the cuffing member under direct endoscopic visualization.

A device for treating a patient having carpal tunnel disease includes a neural stent formed from an elastically deformable material or one that has shape memory properties. The neural stent is in the form of a mesh which, when implanted in a patient, curls about the median nerve below the transverse carpal ligament to separate the two and relieve pressure on the nerve caused by the carpal ligament.

A flexible cutting filament or wire is led through the carpal tunnel, beneath the transverse carpal ligament, by a passer. Thereafter, the opposite ends of the wire are secured in an instrument which tightens the wire and may be used to move the wire as a cutting tool to transect the overlying ligament, while preserving surrounding tissues. The small wire diameter enables minimally invasive techniques to limit post-operative pain and speed recovery.

The subject invention is a surgical scalpel, scalpel instrument and / or scalpel system (collectively, scalpel), particularly designed for use in a transverse carpal ligament surgical procedure, that evaluates an incision path with respect to a nerve in the incision path, and is used to perform the incision if appropriate. The scalpel emits an evaluation signal through a potential incision path through tissue captured by the scalpel. The scalpel utilizes the emitted evaluation signal to determine the presence of a nerve in the incision path. The dissection and evaluation (surgical) instrument includes a blade that is retractable relative to a target tissue capture area thereof. Evaluation may include determining the presence of a nerve before incision and / or the evaluating whether the target tissue has been appropriately captured. A warning is provided when the evaluation determines that a nerve is in the incision path and / or when the captured target tissue is determined to be inappropriate. Alternatively, the surgical instrument may disable extension of the blade when the evaluation determines that a nerve is in the dissection path and / or when the captured target tissue is determined to be inappropriate.

A system, method and / or apparatus is provided for visualization or imaging of the transverse carpal ligament and surrounding structures / features of a hand of a patient, and treatment of the transverse carpal ligament, particularly, but not necessarily, for performing non-invasive carpal tunnel release. The subject invention utilizes ultrasound waves preferably, but not necessarily, in the high frequency range and cavitations to image the transverse carpal ligament (TCL), record its location in three-dimensional space, and perform precision treatment on the transverse carpal ligament. Treatment may range from stretching or lengthening the TCL to complete tissue ablation or dissection of a portion or portions of the TCL (as is performed in a standard carpal tunnel release procedure) in order to release pressure within the carpal tunnel. Particularly, high temperature conditions are generated at target tissue of the TCL resulting in elongation or necrosis / dissection. The subject system, apparatus and / or method provides the surgeon to relieve a patient of carpal tunnel syndrome symptoms in a bloodless, efficient, and accurate manner.

The apparatus of the present invention stretches the carpal ligament and the flexor retinaculum, as well as the superficial structures and muscles of the hand, in a safe manner under precise control of the patient or a healthcare professional. The preferred embodiment of the inventive apparatus includes a first housing with an open side portion adapted and configured to contact and retain the hypothenar region of the patient's hand, with a first edge of the first housing extending along a central longitudinal dorsal portion of the hand, and a second housing with an open side portion adapted and configured to contact and retain the thenar region of the patient's hand, with a second edge of the second housing also extending along a central longitudinal dorsal portion of the hand. A flexible resilient strap is secured to the first housing, and then wrapped around the second housing encompassing the thenar portion of the hand (i.e. around the thumb area), in such a manner as to pull the second housing (and thus the thenar portion of the hand) upward with the first and the second edges of the respective first and second housings serving as a fulcrum around which the hypothenar and thenar portions of the hand are bent. The strap is then secured to itself or to the first and / or the second housing to keep the hypothenar and thenar portions pulled apart during the course of treatment.

Instruments for use in minimally invasive carpal tunnel release include a cannula and a cutting member movable longitudinally within the cannula to advance a cutting blade of the cutting member along a longitudinal slot in the cannula to sever a transverse carpal ligament disposed over the slot. A dilating member is provided for creating a subligamentous space to accommodate the cannula and / or for removing adhered synovium from a lower surface of the ligament. A method for minimally invasive carpal tunnel release involves establishing a proximal entry into the carpal tunnel from an incision in the volar aspect of the forearm, introducing the cannula in the carpal tunnel via the incision, and severing the transverse carpal ligament from proximal to distal with the cutting blade of the cuffing member under direct endoscopic visualization.

A surgical treatment can involve creating a pattern of perforations in a tissue structure to allow lengthening of that tissue structure. For example, a pattern of perforations can be created in the transverse carpal ligament of a patient suffering from carpal tunnel syndrome (CTS) that allows the carpal ligament to lengthen slightly. This lengthening can relieve pressure on the median nerve, thereby reducing the symptoms of CTS while maintaining the structural integrity of the wrist. A surgical instrument for use in perforating a tissue structure (such as the transverse ligament) can be an elongate structure with one or more retractable blades. Such a tool can be used in either an open or minimally invasive procedure to create a desired pattern of perforations in the tissue structure.

Apparatus, systems, and methods for diagnosing carpal tunnel syndrome (“CTS”) are provided. Pressure on the median nerve at the wrist can lead to decreased tactile sensitivity in the fingertips. People with CTS may often experience numbness, tingling, and decreased sensitivity in their finger tips. Compared to a control group, subjects symptomatic of CTS had a greater mean shift (decrease) in tactile sensitivity than the control group when exposed to certain provocations. These provocations include wrist flexion, direct pressure on the transverse carpal ligament area of the wrist, and tendon loading. Additionally, the effects of slight venous occlusion in the forearm were studied. There is an increase in threshold during the recovery period after each provocation. Diagnosis of CTS is provided through monitoring and analysis, preferably with a computer in real-time, of subject's responses to these provocations.

A micro-scalpel used to treat carpal tunnel syndrome has an elongated columnar blade, one end of the blade obliquely cut to form a tip, the obliquely-cut surface of the tip sufficiently sharp to pierce and cut skin of a patient. The other end of the blade is connected to a hollow sleeve connector, and the hollow sleeve connector is combined with a handle. The micro-scalpel is oriented perpendicular to a transverse carpal ligament, and swings from its proximal end toward its distal end to cut the transverse carpal ligament, thereby reducing the number of cuts of the blade and saving time for completing the carpal tunnel surgery.

A method and set of instruments are disclosed particularly useful for carpal tunnel surgeries that allow a precision cut in the transverse carpal ligament (TCL) without direct vision or exposure of the ligament, except for its most proximal edge, but with guidance and safety of the cutting knife, eliminating or, at least very much decreasing, the probability of cutting lines in the wrong direction and inadvertent (iatrogenic) lesions to the surrounding structures. In one preferred embodiment the instrument comprises: a uniquely shaped cannulated guide rod, through which passes a flexible metal guide needle (33) which serves as a guideline for a uniquely shaped cutting knife or fasciotome (25) having a cannulated finger-like prong in the inferior edge of the blade portion of the knife.

A method and apparatus for transecting soft tissue, such as a ligament, and more particularly, the transverse carpal ligament. A retrieval tool and a threadlike cutting element enable the method to performed in a minimally invasive manner. The cutting element is routed into position about the target ligament such that the cutting element both enters and exits the body from the same side of the ligament. The smooth exterior surface of the cutting element serves to provide for a kerf-less cut.

A surgical treatment can involve creating a pattern of perforations in a tissue structure to allow lengthening of that tissue structure. For example, a pattern of perforations can be created in the transverse carpal ligament of a patient suffering from carpal tunnel syndrome (CTS) that allows the carpal ligament to lengthen slightly. This lengthening can relieve pressure on the median nerve, thereby reducing the symptoms of CTS while maintaining the structural integrity of the wrist. A surgical instrument for use in perforating a tissue structure (such as the transverse ligament) can be an elongate structure with one or more retractable blades. Such a tool can be used in either an open or minimally invasive procedure to create a desired pattern of perforations in the tissue structure.

The subject invention is a surgical scalpel, scalpel instrument and / or scalpel system (collectively, scalpel), particularly designed for use in a transverse carpal ligament surgical procedure, that evaluates an incision path with respect to a nerve in the incision path, and is used to perform the incision if appropriate. The scalpel emits an evaluation signal through a potential incision path through tissue captured by the scalpel. The scalpel utilizes the emitted evaluation signal to determine the presence of a nerve in the incision path. The dissection and evaluation (surgical) instrument includes a blade that is retractable relative to a target tissue capture area thereof. Evaluation may include determining the presence of a nerve before incision and / or the evaluating whether the target tissue has been appropriately captured. The surgical instrument may disable extension of the blade when the evaluation determines that a nerve is in the dissection path and / or when the captured target tissue is determined to be inappropriate.

The apparatus of the present invention stretches the carpal ligament and the flexor retinaculum, as well as the superficial structures and muscles of the hand, in a safe manner under precise control of the patient or a healthcare professional. A first embodiment of the inventive apparatus includes a housing for receiving the patient's hand with a bottom portion having a first pressure element positioned to contact the hypothenar region of the patient's hand and a second pressure element positioned to contact the thenar region of the patient's hand, and a top portion having a central longitudinal pressure element positioned to contact the central longitudinal dorsal region of the patient's hand. The first and second pressure elements are connected to active pressure sources (or source), such that when the hand is inserted into the housing, the first and second pressure elements are activated and exert pressure on the respective hypothenar and thenar regions of the hand while the central dorsal portion of the hand presses against the third pressure element. This forces the thenar and hypothenar regions apart thus advantageously stretching the carpal ligament, the flexor retinaculum, and superficial structures and muscles of the hand. In another embodiment of the present invention, the third pressure element is also connected to an active pressure source, such that active pressure is applied to the central dorsal region of the hand, while the first and second pressure elements apply pressure to the hypothenar and thenar regions of the hand.

The invention relates to the field of medical apparatus and instruments, and in particular relates to a carpal canal minimally invasive cutter. The carpal canal minimally invasive cutter comprises a cutter fixed part and a cutter movable part, wherein the cutter fixed part comprises a groove track, the groove track is arranged at the front end of a cutter fixed part body, the cutter movable part comprises a cylinder-shaped long pipe and four grasp plates, the cylinder-shaped long pipe can fix a blade, and an inner chamber of the cutter movable part is fixedly arranged at the rear end of a cutter movable part body. Compared with the prior art, the carpal canal minimally invasive cutter provided by the invention has the advantages that the blade of the carpal canal minimally invasive cutter can be matched with an externally connected endoscope for use, the endoscope is internally equipped with a hard pipe with lamplight, the hard pipe is fixed by the four grasp plates, advances or retreats along with the cylinder-shaped long pipe in the groove track, and is matched with the blade for cutting the transverse carpal ligament, the visualization effect is achieved, and the median nerves and other structures are protected from being injured.

A device for treating a patient having carpal tunnel disease includes a neural stent formed from an elastically deformable material or one that has shape memory properties. The neural stent is in the form of a mesh which, when implanted in a patient, curls about the median nerve below the transverse carpal ligament to separate the two and relieve pressure on the nerve caused by the carpal ligament.

A sling blade apparatus allows percutaneous transaction of fascia or ligaments and in particular for use in transaction of the human transverse carpal ligament. A flexible sling guide is deployed percutaneously beneath the transverse carpal ligament and when drawn taut interfaces intimately with the transverse carpal ligament. The sling in turn serves as a guide along which cutting instruments can be passed to transect the ligament while simultaneously serving as a protective shield for the adjacent median nerve.

A method and apparatus for transecting soft tissue, such as a ligament, and more particularly, the transverse carpal ligament. An hollow introducer needle and a threadlike cutting element enable the method to performed in a minimally invasive manner. The cutting element is routed into position about the target ligament such that the cutting element both enters and exits the body from the same side of the ligament. The substantially smooth exterior surface of the cutting element serves to provide for a kerf-less cut.

The apparatus of the present invention stretches the carpal ligament and the flexor retinaculum, as well as the superficial structures and muscles of the hand, in a safe manner under precise control of the patient or a healthcare professional. Various embodiments of the inventive apparatus commonly include a housing for receiving the hypothenar portion of the patient's hand with an open side portion adapted and configured to contact and retain the hypothenar region of the patient's hand, with an edge of the housing extending along a central longitudinal dorsal portion of the hand, while a flexible resilient strap is wrapped around the thenar portion of the hand (i.e. around the thumb area) in such a manner as to pull the thenar portion of the hand upward with the edge of the housing serving as a fulcrum around which the thenar and hypothenar portions of the hand are bent. The strap is then secured to itself or to the housing to keep the thenar and hypothenar portions pulled apart during the course of treatment. The bending of the thenar and hypothenar regions of the hand around the fulcrum cause the carpal ligament and the flexor retinaculum to stretch expanding the carpal tunnel and relieving pressure on the median nerve.

A system, method and / or apparatus is provided for visualization or imaging of the transverse carpal ligament and surrounding structures / features of a hand of a patient, and treatment of the transverse carpal ligament, particularly, but not necessarily, for performing non-invasive carpal tunnel release. The subject invention utilizes ultrasound waves preferably, but not necessarily, in the high frequency range and cavitations to image the transverse carpal ligament (TCL), record its location in three-dimensional space, and perform precision treatment on the transverse carpal ligament. Treatment may range from stretching or lengthening the TCL to complete tissue ablation or dissection of a portion or portions of the TCL (as is performed in a standard carpal tunnel release procedure) in order to release pressure within the carpal tunnel. Particularly, high temperature conditions are generated at target tissue of the TCL resulting in elongation or necrosis / dissection. The subject system, apparatus and / or method provides the surgeon to relieve a patient of carpal tunnel syndrome symptoms in a bloodless, efficient, and accurate manner.

The invention discloses a transverse carpal ligament closing and separating device for treating carpal tunnel syndrome. The transverse carpal ligament closing and separating device comprises a bottom plate, an upper pressing plate and a hook push broach, wherein the bottom plate is of a hollow structure, one end of the bottom plate is a guide end with a guide structure, the guide end is closed, and the other end of the bottom plate is an insertion end with an insertion opening; an opening is formed in the upper side of the bottom plate, the upper pressing plate is detachably arranged at the opening side of the bottom plate, and a locating space for locating a transverse carpal ligament is formed between the upper pressing plate and the bottom plate and at one end close to the guide end; and one end of the hook push broach is a cutting end with a blade, the other end of the hook push broach is a handheld end, and the cutting end of the hook push broach is inserted from the insertion end of the bottom plate and can reciprocate along the length direction of the bottom plate, so that the blade of the cutting end can cut the transverse carpal ligament in a reciprocating mode. According to the transverse carpal ligament closing and separating device, the transverse carpal ligament is separated in the locating space by adopting the hook push broach, iatrogenic accidents caused due to the fact that a median-nerve superficial palmar arch is clamped and pressed by an operation device are prevented, and it is ensured that the transverse carpal ligament is completely separated and blood vessel nerves are not damaged.

A sling blade apparatus allows percutaneous transaction of fascia or ligaments and in particular for use in transaction of the human transverse carpal ligament. A flexible sling guide is deployed percutaneously beneath the transverse carpal ligament and when drawn taut interfaces intimately with the transverse carpal ligament. The sling in turn serves as a guide along which cutting instruments can be passed to transect the ligament while simultaneously serving as a protective shield for the adjacent median nerve.