84 results about "Percutaneous surgery" patented technology

Systems and methods are described for treating tissue with thermal energy while minimizing the amount of thermal energy to which adjacent tissue is exposed. A surgical instrument for delivering thermal energy to a section of tissue during percutaneous surgery, includes: an elongated shaft having a proximal end and a distal end; and a split tip electrode coupled to the distal end, the split tip electrode i) including a first component and a second component coupled to the first component, and ii) defining a principle axis. The thermal energy is delivered to the section of tissue so as to heat the section of tissue asymmetrically with regard to the principle axis of the split tip electrode. The systems and methods provide advantages in that thermal energy can be directed to one side of the split tip so that a first of two juxtaposed areas of a surgical site can be heated while a second of the two juxtaposed layers is substantially not heated. In alternate embodiments a portion of the site may be actively cooled while an adjacent portion of the site may be actively cooled.

Systems and methods are described for treating tissue with thermal energy while minimizing the amount of thermal energy to which adjacent tissue is exposed. A surgical instrument for delivering thermal energy to a section of tissue during percutaneous surgery, includes: an elongated shaft having a proximal end and a distal end; and a split tip electrode coupled to said distal end, said split tip electrode i) including a first component and a second component coupled to said first component, and ii) defining a principle axis. The thermal energy is delivered to said section of tissue so as to heat said section of tissue asymmetrically with regard to said principle axis of said split tip electrode. The systems and methods provide advantages in that thermal energy can be directed to one side of the split tip so that a first of two juxtaposed areas of a surgical site can be heated while a second of the two juxtaposed layers is substantially not heated. In alternate embodiments a portion of the site may be actively cooled while an adjacent portion of the site may be actively cooled.

Methods and devices for performing percutaneous surgery in a patient are provided. A retractor includes a working channel formed by a first portion coupled to a second portion. The first and second portions are movable relative to one another from an unexpanded configuration to an expanded configuration to increase the size of the working channel along the length of the working channel while minimizing trauma to skin and tissue.

In one embodiment, an apparatus includes a projection having a tapered end portion configured to be inserted percutaneously through tissue. A measurement member is coupled to the projection and is configured to indicate a distance between adjacent anatomical structures. In another embodiment, an apparatus includes a measurement member configured to be percutaneously inserted between adjacent anatomical structures. The measurement member includes a wedge portion that is configured to contact the adjacent anatomical structures when the measurement member is moved distally between the adjacent anatomical structures. A size indicator is coupled to the wedge portion. The size indicator has a plurality of markings and is configured to be viewed on an image of the adjacent anatomical structures with the wedge portion of the measurement member disposed between the adjacent anatomical structures to indicate a distance between the adjacent anatomical structures.

A prosthetic device for replacing a facet joint in the spine of a patient is provided. The prosthetic device includes an anchoring member and a plate member rotatably and pivotably connected to each other by a ball and socket mechanism. The anchoring member is preferably in the form of a bone screw for placement into the pedicle / facet intersection of a vertebrae, and the plate member is provided with securing holes for securing the plate member to an adjacent vertebrae. A minimally invasive, percutaneous surgical method is also provided for replacing the facet joint in the spine, and a kit for performing the surgical method is also provided.

A method for treating stenosis in a spine comprises percutaneously accessing the epidural space in a stenotic region of interest, compressing the thecal sac in the region of interest to form a safety zonem, inserting a tissue removal tool into tissue in the working zone, using the tool to percutaneously reduce the stenosis; and utilizing imaging to visualize the position of the tool during at least a part of the reduction step. A tissue excision system for performing percutaneous surgery, comprises a cannula comprising a tissue-penetrating member having a distal end defining an aperture on one side thereof, an occluding member slidably received on or in the cannula and closing the aperture when the occluding member is adjacent the cannula distal end, means for engaging adjacent tissue via the aperture, and cutting means for resecting a section of the engaged tissue.

An apparatus and method are provided for precisely isolating a target lesion in a patient's body tissue, resulting in a high likelihood of “clean” margins about the lesion when it is removed for diagnosis and / or therapy. This approach advantageously will often result in the ability to both diagnose and treat a malignant lesion with only a single percutaneous procedure, with no follow-up percutaneous or surgical procedure required, while minimizing the risk of migration of possibly cancerous cells from the lesion to surrounding tissue or the bloodstream. In particular, the apparatus comprises a biopsy instrument having a distal end adapted for entry into the patient's body, a longitudinal shaft, and a cutting element disposed along the shaft. The cutting element is actuatable between a radially retracted position and a radially extended position. Advantageously, the instrument is rotatable about its axis in the radially extended position to isolate a desired tissue specimen from surrounding tissue by defining a peripheral margin about the tissue specimen. Once the tissue specimen is isolated, it may be segmented by further manipulation of the cutting element, after which the tissue segments are preferably individually removed from the patient's body through a cannula or the like. Alternatively, the specimen may be encapsulated and removed as an intact piece.

The device of the invention consists of a plurality of tubular cannulae, which prior to the surgery, are linked together at their distal ends by flexible elements, such as wires or threads. All the threads, the number of which is one less than the number of the used cannulae, are passed through one of the cannulae and the distal ends of the threads are either attached to the walls of other cannulae, at their distal ends, or pulled back through one of the cannula forming the loop at the distal end and fixed at the proximal end of the cannula. During surgery, the cannulae with their distal ends being linked are inserted into the patient's body through an incision and then the cannulae are used for guiding various surgical tools. Due to flexible linking of the cannulae at their distal ends, the cannulae can be easily manipulated without disconnection and without a need for use extraneous X-raying for reorientation of the cannulae.

A method for treating stenosis in a spine comprises percutaneously accessing the epidural space in a stenotic region of interest, compressing the thecal sac in the region of interest to form a safety zonem, inserting a tissue removal tool into tissue in the working zone, using the tool to percutaneously reduce the stenosis; and utilizing imaging to visualize the position of the tool during at least a part of the reduction step. A tissue excision system for performing percutaneous surgery, comprises a cannula comprising a tissue-penetrating member having a distal end defining an aperture on one side thereof, an occluding member slidably received on or in the cannula and closing the aperture when the occluding member is adjacent the cannula distal end, means for engaging adjacent tissue via the aperture, and cutting means for resecting a section of the engaged tissue.

In one embodiment, an apparatus includes a projection having a tapered end portion configured to be inserted percutaneously through tissue. A measurement member is coupled to the projection and is configured to indicate a distance between adjacent anatomical structures. In another embodiment, an apparatus includes a measurement member configured to be percutaneously inserted between adjacent anatomical structures. The measurement member includes a wedge portion that is configured to contact the adjacent anatomical structures when the measurement member is moved distally between the adjacent anatomical structures. A size indicator is coupled to the wedge portion. The size indicator has a plurality of markings and is configured to be viewed on an image of the adjacent anatomical structures with the wedge portion of the measurement member disposed between the adjacent anatomical structures to indicate a distance between the adjacent anatomical structures.

A method for treating stenosis in a spine comprises percutaneously accessing the epidural space in a stenotic region of interest, compressing the thecal sac in the region of interest to form a safety zonem, inserting a tissue removal tool into tissue in the working zone, using the tool to percutaneously reduce the stenosis; and utilizing imaging to visualize the position of the tool during at least a part of the reduction step. A tissue excision system for performing percutaneous surgery, comprises a cannula comprising a tissue-penetrating member having a distal end defining an aperture on one side thereof, an occluding member slidably received on or in the cannula and closing the aperture when the occluding member is adjacent the cannula distal end, means for engaging adjacent tissue via the aperture, and cutting means for resecting a section of the engaged tissue.

An apparatus and method are provided for precisely isolating a target lesion in a patient's body tissue, resulting in a high likelihood of “clean” margins about the lesion when it is removed for diagnosis and / or therapy. This approach advantageously will often result in the ability to both diagnose and treat a malignant lesion with only a single percutaneous procedure, with no follow-up percutaneous or surgical procedure required, while minimizing the risk of migration of possibly cancerous cells from the lesion to surrounding tissue or the bloodstream. In particular, the apparatus comprises a biopsy instrument having a distal end adapted for entry into the patient's body, a longitudinal shaft, and a cutting element disposed along the shaft. The cutting element is actuatable between a radially retracted position and a radially extended position. Advantageously, the instrument is rotatable about its axis in the radially extended position to isolate a desired tissue specimen from surrounding tissue by defining a peripheral margin about the tissue specimen. Once the tissue specimen is isolated, it may be segmented by further manipulation of the cutting element, after which the tissue segments are preferably individually removed from the patient's body through a cannula or the like. Alternatively, the specimen may be encapsulated and removed as an intact piece.

In one embodiment, an apparatus includes a projection having a tapered end portion configured to be inserted percutaneously through tissue. A measurement member is coupled to the projection and is configured to indicate a distance between adjacent anatomical structures. In another embodiment, an apparatus includes a measurement member configured to be percutaneously inserted between adjacent anatomical structures. The measurement member includes a wedge portion that is configured to contact the adjacent anatomical structures when the measurement member is moved distally between the adjacent anatomical structures. A size indicator is coupled to the wedge portion. The size indicator has a plurality of markings and is configured to be viewed on an image of the adjacent anatomical structures with the wedge portion of the measurement member disposed between the adjacent anatomical structures to indicate a distance between the adjacent anatomical structures.

A retractor for percutaneous surgery in a patient which includes an elongate retractor tube composed of circumferentially arranged elongate independent tube segments with proximal ends of the tube segments respectively hinged to a unitary collar whereby the distal ends of the tube segments may be outwardly expanded in umbrella fashion by outwardly pivoting the segments about their respective hinges for thereby retracting surrounding tissue. The distal end of the retractor tube is provided with a tapered distal end suitably dimensioned for insertion into a stab incision. An internally open expansion collet is coaxially received in the collar for adjustable coaxial advancement downwardly into the collar toward the retractor tube segments and fulcrum tabs protrude inwardly and upwardly towards the expansion collet from each tube segment adjacent a respective hinge. The fulcrum tabs are sized for engaging a bottom end of the collet for thereby progressively pivoting the segments outward about their hinges as the collet advances downwardly into the collar.

Described are devices, methods and systems useful for achieving occlusion of vascular vessels. Percutaneous procedures are used to occlude and obliterate the greater saphenous vein, for example in the treatment of varicose vein condition caused by venous reflux. Certain embodiments encompass the deployment of one or more vascular occlusion devices via a through-and-through percutaneous procedure that leaves the vascular occlusion device or devices in a through-and-through condition.

A deflection and support catheter provided for improved manipulation of elongated medical devices used during percutaneous procedures in difficult to reach situations. In particular, the deflection and support catheters can facilitate placement of guidewires, guide catheters, and intervention devices such as angioplasty balloons and stent delivery devices.

In one embodiment, there is disclosed a method for repairing a heart of a human, comprising introducing a collapsed shaping device through the skin into the vascular system of the human, delivering the shaping device into a left ventricle through the arteries, once inside the left ventricle, expanding the shaping device to an expanded shape, imbricating a wall of the ventricle over the shaping device, collapsing the shaping device, and removing the shaping device from the left ventricle such that the ventricle is restored to an appropriate size.

Disclosed herein are methods and surgical kits that can be used to fuse facet joints via a minimally invasive procedure (including an arthroscopic or percutaneous procedure). An exemplary method includes creating an incision; locating a facet joint with a distal end of a pin; sliding a substantially hollow drill guide over said pin wherein said drill guide comprises a proximal end, a distal end; removing said pin from within said drill guide; inserting a drill bit into said drill guide; drilling a hole into a bone of said facet joint; removing said drill bit; inserting a facet joint bone plug into said hole using a bone plug inserter having a raised portion at or near is proximal end, wherein said raised portion prevents over-insertion of said bone plug; and removing said drill guide.

Disclosed herein are methods and surgical kits that can be used to fuse facet joints via a minimally invasive procedure (including an arthroscopic or percutaneous procedure). An exemplary method includes creating an incision; locating a facet joint with a distal end of a pin; sliding a substantially hollow drill guide over said pin wherein said drill guide comprises a proximal end, a distal end; removing said pin from within said drill guide; inserting a drill bit into said drill guide; drilling a hole into a bone of said facet joint; removing said drill bit; inserting a facet joint bone plug into said hole using a bone plug inserter having a raised portion at or near is proximal end, wherein said raised portion prevents over-insertion of said bone plug; and removing said drill guide.

An anatomic device delivery and positioning system has a stabilizing guide wire for placement of a catheter or other medical device or material into a vessel or cavity of a tissue or organ within a body of a living subject into which the guide wire is insertable. The guide wire includes an elongated member having a proximal end and a distal end, the proximal end to extend out of the body and the distal end to extend into the body, the distal end having an expandable portion that expands from a compressed condition when inside of a delivery tube or catheter to an expanded condition when outside of the delivery tube or catheter. A method is also disclosed of performing a percutaneous procedure within a vessel or cavity of a tissue or organ of a subject using the guide wire, particularly but not exclusively involving a heart procedure.

A retractor system for percutaneous surgery in a patient includes first and second retractor portions positionable opposite one another in an incision of the patient. The system also includes at least one actuating member operable to provide an oscillating motion to at least one of the first and second retractor portions. The actuating member is in communication with a controller and is responsive to the controller to move and adjust at least one of the first and second retractor portions between a first position and a second position. The system also includes at least one pressure sensor and display and at least one timing circuit with display. In another form, a method is directed to retracting tissue for percutaneous access to a surgical site in a patient using the pressure sensors and display as will as the timing circuit and display to assure that the amount of pressure applied and the duration does not exceed pre-determined values.

A multiportal device for percutaneous surgery consists of a guiding device with a radial arm that supports an auxiliary guiding device, which can slide along the arm and can be fixed in a require angular position on the arm. The device also includes a first cannula, which can be inserted into the patient's body through the guiding device and can be fixed in a required axial position, and a second cannula, which can be inserted into the second guiding unit and fixed therein. The arch-shaped form of the arm ensures intersection of distal ends of both cannulae in one point aimed at the symptomatic site where surgery has to be done. The device is provided with a linking mechanism that links the distal ends of both cannulae in their position inside the body of a patient. In the engaged state of the linking device, the cannulae still have some freedom of relative movements that may be required for manipulation with cannulae during the surgery. The invention also relates to a method of using the multiportal device for percutaneous surgery. The device allows insertion of a plurality of cannulae and permanently maintaining them in controlled positions without resorting to additional X-ray.

A lordotic guard and method for guiding a bone removal device to form an implantation space in the human spine and, if desired, for inserting a spinal implant into the implantation space.

A targeting device for providing a series of coordinates / lines within a sheet of sterile, flexible material with an adherent surface which is applied to the skin (after suitable surgical preparation). The sheet is non-porous and may have a topical antiseptic on the side which is applied to the skin. A fluoroscope or roentgenographic image of the portion of the body to which the adherent film is applied will show the underlying skeletal and radiopaque elements as well as the overlying surgical grid. Once the targeting device is applied, the coordinates on the grid lines are clearly visible on the surface of the skin as well as on the fluoroscopic or radiographic image and by knowing the direction of the fluoroscopic or radiographic beam, the operator will be able to thereby correlate a specific locus on the skin with an underlying skeletal element or other underlying radiopaque structure. By applying the targeting device to the part of the body in a circumferential or nearly circumferential manner, and utilizing a radiolucent operating room table, and a radiograph or C-arm fluoroscope, targeting techniques using the targeting device can be utilized at surgery. Multiple targeting or percutaneous procedures can be performed at the same sitting with the application of a single device.

An assistant device for percutaneous puncture is disclosed. The assistance device includes a fixing element, a first rotatable element, a supporting element and a second rotatable element. The fixing element has a first rail, and the first rotatable element is slidably disposed on the first rail. The supporting element is connected to the first rotatable element. The second rotatable element is slidably disposed on the supporting element and has a puncture restraint pore.

A system and method for using pre-procedural images for registration for image-guided therapy (IGT), also referred to as image-guided intervention (IGI), in percutaneous surgical application. Pseudo-features and patient abdomen and organ surfaces are used for registration and to establish the relationship needed for guidance. Three-dimensional visualizations of the vasculature, tumor(s), and organs may be generated for enhanced guidance information. The invention facilitates extensive pre-procedural planning, thereby significantly reducing procedural times. It also minimizes the patient exposure to radiation.

An assistant device for percutaneous puncture is disclosed. The assistance device includes a fixing element, a first rotatable element, a supporting element and a second rotatable element. The fixing element has a first rail, and the first rotatable element is slidably disposed on the first rail. The supporting element is connected to the first rotatable element. The second rotatable element is slidably disposed on the supporting element and has a puncture restraint pore.