Source: https://patents.google.com/patent/US8529498B2/en
Timestamp: 2019-05-27 02:10:51
Document Index: 277940036

Matched Legal Cases: ['§119', 'Application No. 2', 'Application No. 2002364122', 'Application No. 02799196', 'Application No. 02', 'Application No. 02']

US8529498B2 - Liquid jet surgical instruments incorporating channel openings aligned along the jet beam - Google Patents
Liquid jet surgical instruments incorporating channel openings aligned along the jet beam Download PDF
US8529498B2
US8529498B2 US12/207,282 US20728208A US8529498B2 US 8529498 B2 US8529498 B2 US 8529498B2 US 20728208 A US20728208 A US 20728208A US 8529498 B2 US8529498 B2 US 8529498B2
US12/207,282
US20090076440A1 (en
Donald C. Freeman, Jr.
Edward J. Bromander
2001-11-21 Priority to US33215601P priority Critical
2002-11-21 Priority to US10/302,766 priority patent/US7431711B2/en
2008-09-09 Application filed by Smith and Nephew Inc filed Critical Smith and Nephew Inc
2008-09-09 Priority to US12/207,282 priority patent/US8529498B2/en
2009-03-19 Publication of US20090076440A1 publication Critical patent/US20090076440A1/en
2013-08-07 Assigned to HYDROCISION, INC. reassignment HYDROCISION, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: FREEMAN, DONALD C., JR., BROMANDER, EDWARD, MOUTAFIS, TIMOTHY E.
2013-09-10 Publication of US8529498B2 publication Critical patent/US8529498B2/en
Certain embodiments of the surgical instruments provided according to the invention utilize a channel positioned adjacent to and downstream of a liquid jet-forming nozzle such that at least a portion of the liquid jet passes at least one of within the channel and adjacent to and along the length of at least a portion of a longitudinally-oriented opening in the channel, when the instrument is in operation. The use of such channels in certain embodiments of the inventive surgical instruments can enable the instruments to provide enhanced control over the depth and degree of cutting and/or ablation of tissue; and/or can provide improved and enhanced functionality for cleaning, debriding, and/or trimming and cutting a tissue/surface; and/or can provide longer effective liquid jet beam cutting/ablation lengths by reducing the degree of dispersion of the jet along its length.
This non-provisional application is a divisional application of U.S. application Ser. No. 10/302,766, filed Nov. 21, 2002 now U.S. Pat. No. 7,431,711, which claims the benefit under Title 35, U.S.C. §119(e) of U.S. provisional application Ser. No. 60/332,156, filed Nov. 21, 2001, the entire content of each application is incorporated herein by reference.
FIG. 5H is a fragmentary longitudinal cross-sectional view of the embodiment of FIG. 5G showing the pressure relief valve in a closed configuration;
FIG. 8C is an end view of the channel-providing component of FIG. 8A, as viewed from the right of FIG. 8B;
FIG. 12B is a schematic top perspective view of the jet tip of FIG. 12A;
The term “beam height” or “jet beam height” refers to a shortest distance existing between the location of a center line defining the central region of the jet beam formed by the nozzle, at a given point along the length of jet beam travel, and a plane tangent to the tissue-contacting surfaces defining the opposed sides of the longitudinally-oriented opening of the channel (i.e. a plane co-planar with the plane defining the longitudinally-oriented opening of the channel). Stated another way, the beam height can also be defined as the perpendicular distance between a center line defining the central region of the jet beam and the plane defining the longitudinally-oriented opening, as measured in a plane that is transverse to the longitudinal axis of the channel and that is perpendicular to the plane defining the longitudinally-oriented opening. It should be noted that this height can, in some embodiments, vary along the length of the jet beam (e.g., for embodiments wherein the jet beam is directed at an up or down angle with respect to the longitudinal axis of the channel—i.e., at an angle with respect to the longitudinal axis within a plane perpendicular to both the plane defining longitudinally-oriented opening and a plane that is transverse to the longitudinal axis of the channel. Beam heights have positive values when the center line of the jet beam is located external to the interior region of the channel and have negative values when the centerline of the jet beam is located within the channel. A beam height of zero indicates that the location of the centerline of the jet beam is within the plane defining longitudinally-oriented opening of the channel (i.e. the plane tangent to the tissue-contacting surfaces defining the opposed sides of the longitudinally-oriented opening of the channel). Also, where reference is made herein to “medical” or “surgical” uses, it is intended that either of these terms encompass the other as well as use in a veterinary or cosmetic application, unless otherwise specified.
In some embodiments, as illustrated, the nozzles of the inventive instruments can comprises a small diameter hole etched into the side of the high pressure tube. Such holes can be conveniently formed by techniques known in the prior art such as those including, but not limited to, electrochemical etching (e.g. “EDM” in which a thin electrode is positioned at the site of the nozzle and an electrical potential is applied to cause electricity to run from the electrode to the site thereby eroding a hole at the site), laser etching, micro-sandblasting, or mechanical drilling. In alternative embodiments, as discussed in more detail in Applicants' U.S. Pat. No 6,375,635, the nozzle can be formed by drawing down the distal end of the high pressure lumen to the desired nozzle diameter and, in some embodiments if necessary or desired, bending and/or offsetting the necked down region of the lumen to enable the liquid jet to be directed along the longitudinal axis of the channel of the instrument. In yet other embodiments, the nozzle could be separately fabricated and subsequently connected to the tubing. In one particular embodiment, the nozzle is formed within a cylindrical insert which is inserted in a larger diameter hole in the sidewall of the high pressure lumen by and secured by an appropriate technique including, for example, press fitting and/or brazing.
Jet beam 13 passing within and along channel 9, when the instrument is utilized in a surgical procedure, will interact with tissue apposed to longitudinally-oriented opening 8 of channel 9 and in contact with tissue-contacting surfaces 11. After passing through channel 9, jet beam 13 passes into a connecting sleeve 12, forming a distal end of the evacuation lumen 16. Connecting sleeve 12 includes at its distal end an opening 14 comprising a jet-receiving opening. Channel 9 is connected in fluid communication with the distal end of the evacuation lumen 16 via connecting sleeve 12. Connecting sleeve 12, as illustrated, is configured to hold channel 9 in place in the jet tip, optionally in cooperation with high pressure tube 10 or other restraining means at the distal end of the channel. The connection between component 7 carrying channel 9 and sleeve 12 can be made more permanent, in some embodiments, by a variety of well-known techniques, for example by gluing, brazing, welding, press fitting, or by other means known to those of ordinary skill in the art. In alternative embodiments, the connection can be non-permanent and channel-providing component 7 can comprise an insert that is removable and replaceable by an operator of the instrument. In alternative embodiments, sleeve 12 can be integrally formed with component 7 and/or evacuation lumen 16. In certain embodiments, as illustrated, sleeve 12 can be separate from and permanently or reversibly connected to evacuation lumen 16, which is configured to evacuate material from the jet tip to the proximal end of the instrument (not shown) and, typically, to a drain (not shown) through an evacuation tube of the instrument (such as evacuation tube 86 shown in FIG. 7 below).
In some embodiments, evacuation efficiency can be enhanced by providing an enlargement in the internal diameter of the connector 12 and/or evacuation lumen 16 proximally of the jet-receiving opening 14 and proximally of any constriction forming a venturi, should one be present. In certain such embodiments, the inner diameter of the sleeve and/or evacuation lumen increases from a certain minimum value at a first, distal location to a certain maximum value at a more proximal location, whereinafter, the internal diameter of the evacuation lumen remains constant. More detail concerning the configuration of the evacuation lumen in such embodiments can be found in Applicants' U.S. Pat. No. 6,375,635. In certain embodiments, wherein the liquid jet is not directed in parallel to the longitudinal axis of channel 9, as illustrated in FIG. 2A, but rather is angled downwardly into the channel, with respect to the orientation as illustrated, evacuation of fluid can be further facilitated by setting the longitudinal axis of the connecting sleeve at an angle with respect to the longitudinal axis 17 of the distal end of evacuation lumen 16 so as to match the downward angle of the jet beam emitted from the nozzle so that the longitudinal axis of the connecting sleeve is colinear with the trajectory of the jet beam. Such a configuration has relevance for embodiments including angled jet beams such as those illustrated below in FIGS. 12A-12D. Also, in certain embodiments, to facilitate the manipulation of the instrument and to enable the tissue contacting surfaces 11 of channel 9 to be apposed to a tissue to be treated with the instrument more easily, the longitudinal axis 17 of the jet tip can be set at an angle with respect to the longitudinal axis 18 of the proximal end/body (not shown) of the instrument. In certain embodiments, the angle between longitudinal axis 17 of the jet tip and longitudinal axis 18 of the proximal end (not shown) of the instrument can range from about 15 degrees to about 90 degrees to provide desirable ergonomics for an operator of the instrument.
FIG. 2B also illustrates an alternative for providing vent apertures along the length of channel 9. Channel 9 includes vent apertures 21 formed in bottommost surface 6 of the channel. These vent apertures can provide controlled relief of the vacuum tending to be formed in the interior region of channel 9, which can tend to press the jet tip against the tissue, as is further discussed below. Vent holes 21 can be drilled or otherwise formed at a particular angle 22 measured in a plane normal to the longitudinal axis 17 of channel 9. In certain embodiments, angle 22 is greater than 0 (i.e., vent holes 21 slant distally from bottommost surface 6 of channel 9 to the outer surface of component 7). Such a slant can prevent inadvertent entry of part of jet beam 13 into one or more of the vent holes during operation. Typically, angle 22 would range from between about 45 degrees to about 60 degrees. In alternative embodiments, instead of locating vent holes 21 such that they are in fluid communication with bottom surface 6 of channel 9, vent holes could be placed in fluid communication with one or both of the side surfaces of channel 9.
For embodiments where controlled depth tissue cutting is desirable, as discussed above, it can be advantageous to provide a jet tip having a nozzle positioned, with respect to the channel, such that the jet beam has a positive beam height and passes adjacent to and externally of the channel over at least a portion of its length. In such embodiments, for example such as those illustrated below in FIGS. 11 and 12A-12D, the depth of cut can be a function of, and can in sonic embodiments approximate, the maximum beam height of the jet beam over its length of travel.
In certain embodiments of the invention, one or more geometric and/or functional properties of the jet tip of the invention can be configured to be adjustable by an operator of the inventive surgical instrument, optionally, intraoperatively. Such adjustability can give additional flexibility to the operator in conducting certain medical and surgical procedures.
In one such embodiment, illustrated in FIGS. 3 and 4, a surgical instrument can be provided with a jet tip allowing the beam height to be varied. In the jet tip embodiment 41 illustrated in FIG. 3, adjustment of the beam height can be effected through the use of the set screw 26 configured to be in contact with, and, alternatively, attached to high pressure lumen 10. Set screw 26 is threaded through a threaded hole 27 in a distal extension 28 of the component 7 forming the channel 9. Set screw 26 acts on high pressure tubing 10 when turned, thereby displacing nozzle 2 with respect to channel 9, thus altering the beam height of jet beam 13. Thus, turning the set screw 26 can increase or decrease the beam height of the jet beam by displacement of the distal end of the high pressure tube. As would be apparent to those of ordinary skill in the art, various other means could alternatively be used to vary the beam height of the jet within or adjacent to the channel, each of which would be within the scope of the present invention.
In certain embodiments, surgical instruments provided according to the invention can be configured so that the jet-interacting channel is contained within a channel-providing insert that can be removed and replaced by an operator of the instrument with another insert having a differently configured channel therein. In one such embodiment, the channel could be formed in a component similar to components 7 illustrated above, which component is not permanently affixed to sleeve 12, so that it can be removed and replaced with a similar component having a different channel shape, size, etc., thereby providing a different balance of instrument properties. For example, in one such application, after cutting damaged tissue utilizing an insert having one type of channel therein, an insert having different type of channel could be substituted to facilitate rapid and thorough lavage of the previously treated area. Replacement channel-providing components could, in one embodiment, be simply slipped into the sleeve and retained in place by high pressure lumen 10, or, alternatively, could he secured by a clip or other securing element. For certain embodiments where the channel is provided in a component formed of a sheet of metal, such component could be compressed slightly during insertion of the component into the sleeve element, and held in place in the sleeve by the natural spring action of the metal sheet.
Referring to FIGS. 8A-8C, the illustrated channel-providing insert 100 includes a “U” shaped channel 102 therein. The channel 102 includes a longitudinally-oriented opening 104, extending along the entire length of the channel, having a width 106 of about 0.06 inch. Channel depth 108 is about 0.075 inch. Downstream end 110 of the insert has been provided with a reduced diameter to facilitate a slip fit into a connecting sleeve (not shown), such as connecting sleeve 12 illustrated previously. Three vent aperture holes 21 having a diameter 112 of about 0.02 inch have been drilled in insert 100 at an angle 114 of about 60° with respect to longitudinal axis 17 of channel 102. Also provided is a notch 116 at the downstream, distal end of the channel to accommodate passage of the high pressure lumen (not shown), which, in the illustrated embodiment, would enter the channel through the bottom 118 of the insert. In the illustrated embodiment, width 106 of the longitudinally-oriented opening 104 of channel 102 remains essentially constant over the effective length 118 of the longitudinally-oriented opening 104 of channel 102, when the insert is assembled in an operative configuration in a jet tip.
While several embodiments of the invention have been described and illustrated herein, those of ordinary skill in the art will readily envision a variety of other means and structures for performing the functions and/or obtaining the results or advantages described herein, and each of such variations or modifications is deemed to be within the scope of the present invention. More generally, those skilled in the art would readily appreciate that all parameters, dimensions, materials, and configurations described herein are meant to be exemplary and that actual parameters, dimensions, materials, and configurations will depend upon specific applications for which the teachings of the present invention are used. Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments of the invention described herein. It is, therefore, to be understood that the foregoing embodiments are presented by way of example only and that, within the scope of the appended claims and equivalents thereto, the invention may be practiced otherwise than as specifically described. The present invention is directed to each individual feature, system, material and/or method described herein. In addition, any combination of two or more such features, systems, materials and/or methods, provided that such features, systems, materials and/or methods are not mutually inconsistent, is included within the scope of the present invention. In the claims (as well as in the specification above), all transitional phrases or phrases of inclusion, such as “comprising,” “including,” “carrying,” “having,” “containing,” “composed of,” “made of,” “formed of’ and the like shall be interpreted to be open-ended, i.e. to mean “including but not limited to.” Only the transitional phrases or phrases of inclusion “consisting of’ and “consisting essentially of’ are to be interpreted as closed or semi-closed phrases, respectively.
a nozzle in fluid communication with the pressure lumen that is shaped to form a liquid jet as the liquid flows therethrough;
a channel, having a depth and a length, the length being defined along a longitudinal axis of the channel, the channel including a tissue-contacting portion including a longitudinally-oriented opening to a surrounding environment extending along at least a portion of the length of the channel, the longitudinally-oriented opening having a total effective length, as measured along the length of the channel, and a width, as measured in a direction perpendicular to the longitudinal axis of the channel, wherein the total effective length of the longitudinally-oriented opening is greater than the width of the longitudinally-oriented opening; and
at least one vent aperture in the channel configured and positioned to provide fluid communication between an interior region of the channel and the surrounding environment when the longitudinally-oriented opening of the tissue-contacting portion of the channel is occluded, the vent aperture being configured and positioned to act as a suction break to reduce the level of suction created within the interior region of the channel, wherein
the channel is positioned adjacent to and downstream of the nozzle such that the liquid jet, over at least a portion of its length, passes at least one of within the channel and adjacent to the channel, and also passes along a length of at least a portion of the longitudinally-oriented opening of the channel, when the instrument is in operation; and
an evacuation lumen comprising a jet-receiving opening that is separate and distinct from the vent aperture and that is located opposite a jet opening of the nozzle and adjacent to and downstream of the channel, wherein the evacuation lumen is constructed and positioned to enable it to collect liquid comprising the liquid jet formed by the nozzle, when the instrument is in operation.
2. The surgical instrument as in claim 1, wherein a downstream end of the channel is connected in fluid communication with the jet-receiving opening of the evacuation lumen.
3. The surgical instrument as in claim 2, wherein the downstream end of the channel is connected to the evacuation lumen by a sleeve element.
4. The surgical instrument as in claim 2, wherein the evacuation lumen is shaped and positionable to enable evacuation of essentially all of the liquid comprising the liquid jet from the jet-receiving opening to the proximal end of the instrument, without the need for an external source of suction.
5. The surgical instrument as in claim 1, wherein the at least one vent aperture comprises an inlet opening at an upstream end of the channel.
6. The surgical instrument as in claim 1, wherein the at least one vent aperture comprises at least one vent hole positioned at a location along the length of the channel.
7. The surgical instrument as in claim 1, wherein the at least one vent aperture comprises at least one indentation in a tissue-contacting surface of the tissue-contacting portion of the channel.
8. The surgical instrument as in claim 1, wherein a total cross sectional area of the at least one vent aperture is between about 2% and about 150% of the total area of the longitudinally oriented opening of the channel.
9. The surgical instrument as in claim 8, wherein the total cross sectional area of the at least one vent aperture is between about 2% and about 40% of the total area of the longitudinally oriented opening of the channel.
10. The surgical instrument as in claim 9, wherein the total cross sectional area of the at least one vent aperture is between about 2% and about 10% of the total area of the longitudinally oriented opening of the channel.
11. The surgical instrument as in claim 10, wherein the total cross sectional area of the at least one vent aperture is about 4% of the total area of the longitudinally-oriented opening of the channel.
12. The surgical instrument as in claim 8, wherein the total open area of the at least one vent aperture is adjustable by an operator of the surgical instrument.
13. The surgical instrument as in claim 12, wherein the total open area of the at least one vent aperture can be varied intraoperatively.
14. The surgical instrument as in claim 8, wherein the total open area of the at least one vent aperture is configured to be automatically adjustable based on a level of suction present within the interior region of the channel during operation of the surgical instrument.
US12/207,282 2001-11-21 2008-09-09 Liquid jet surgical instruments incorporating channel openings aligned along the jet beam Active 2025-11-30 US8529498B2 (en)
US33215601P true 2001-11-21 2001-11-21
US10/302,766 US7431711B2 (en) 2001-11-21 2002-11-21 Liquid jet surgical instruments incorporating channel openings aligned along the jet beam
US12/207,282 US8529498B2 (en) 2001-11-21 2008-09-09 Liquid jet surgical instruments incorporating channel openings aligned along the jet beam
US10/302,766 Division US7431711B2 (en) 2001-11-21 2002-11-21 Liquid jet surgical instruments incorporating channel openings aligned along the jet beam
US20090076440A1 US20090076440A1 (en) 2009-03-19
US8529498B2 true US8529498B2 (en) 2013-09-10
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US10/302,766 Active 2022-12-02 US7431711B2 (en) 2001-11-21 2002-11-21 Liquid jet surgical instruments incorporating channel openings aligned along the jet beam
US12/207,282 Active 2025-11-30 US8529498B2 (en) 2001-11-21 2008-09-09 Liquid jet surgical instruments incorporating channel openings aligned along the jet beam
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JP (1) JP4346443B2 (en)
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WO (1) WO2003045259A1 (en)
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2002-11-21 CA CA 2495911 patent/CA2495911C/en active Active
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2002-11-21 EP EP02799196A patent/EP1485032B1/en active Active
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2002-11-21 US US10/302,766 patent/US7431711B2/en active Active
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CA2495911C (en) 2011-06-07
US20030125660A1 (en) 2003-07-03
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Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MOUTAFIS, TIMOTHY E.;FREEMAN, DONALD C., JR.;BROMANDER, EDWARD;SIGNING DATES FROM 20030211 TO 20030221;REEL/FRAME:030957/0298