WO2009152919A1 - Dispositif d'élimination de tissus osseux lors d'opérations endoscopiques - Google Patents
Dispositif d'élimination de tissus osseux lors d'opérations endoscopiques Download PDFInfo
- Publication number
- WO2009152919A1 WO2009152919A1 PCT/EP2009/003672 EP2009003672W WO2009152919A1 WO 2009152919 A1 WO2009152919 A1 WO 2009152919A1 EP 2009003672 W EP2009003672 W EP 2009003672W WO 2009152919 A1 WO2009152919 A1 WO 2009152919A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- cutting
- cutting tool
- tool
- distal
- probe
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
- A61B17/1617—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material with mobile or detachable parts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1637—Hollow drills or saws producing a curved cut, e.g. cylindrical
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
Definitions
- the invention relates to a device for removing bone tissue during endoscopic operations, with at least one cutting tool arranged concentrically around an elongated probe.
- the invention is particularly useful in the performance of endoscopic surgeries for the treatment of herniated discs, although the invention is not necessarily limited to this purpose.
- a first elongated member having a blunt conical tip is first inserted to accommodate soft tissue close to the damaged disc to be treated.
- a fine cannula is inserted over this, the inner diameter of which corresponds to the outer diameter of the first elongate element.
- the Au The diameter of this cannula may be between 2 and 10 mm, the most common being that the cannulas have an outside diameter of 6 mm.
- the cannula is blunt and may have various geometries at its distal end, with one distal edge generally generally oblique to the axis of the cannula, for better visibility of the working area.
- the first elongate member is withdrawn leaving an open access channel open to the area of the damaged disc into which an optical probe is inserted which fits snugly into this channel and, in turn, channels of pressurized water for cleaning / aspiration of elements and, in some models, also working channels for various devices for treating or handling the tissue.
- the previously known techniques offer three possible solutions.
- the first is a cutting tool that is sized to be inserted into a working channel of the optical probe. This solution allows the user to cut bone tissue while maintaining visual control of its operations.
- the tool necessarily has a very small diameter must be (a maximum of 1.5 mm in diameter) and that the operations to remove the bone tissue may take too long, which ultimately may even lead to harm to the patient.
- a second known solution is to pull out the optical probe, and instead use a larger diameter cutting tool.
- the problem is that the user is forced to perform the operations without a direct view of the soft tissues present, with the concomitant danger of damaging the nerve tissue associated with the epidural space.
- the cutting tool is usually a cylinder whose distal end is perpendicular to the cylinder axis. Said distal end consists of a generally saw-shaped cutting area, the diameter of the tool substantially changing for each of the two possible solutions.
- the invention includes an apparatus for removing bone tissue in endoscopic operations, comprising at least one cutting tool concentrically disposed about an elongated probe, wherein the cutting tool comprises a distal cutting portion having a conical geometry, the distal tapered surface having lateral cutting edges.
- the cutting edges may be formed for right- and / or left-side cutting.
- the new device has essentially two advantages over the previously known devices.
- the tapered cutting area allows a progressive cut of the area to be removed.
- there is a lateral cutting edge for cutting on the left and right
- proper control of the cut of the tool is achieved, which cuts only when the tool is rotated in the direction in which the cut is made. In this way, in comparison to the previously known possibilities, both the
- the conical distal region is at the
- the cutting edges of the cutting tool are parallel to each other, and more preferably, they extend helically on the conical surface, leaving grooves for receiving the removed tissue.
- the device in a simpler embodiment consists of a probe and a cutting tool, yet it can be supplemented with other devices known per se.
- the device can furthermore have more than one cutting tool with the features described above. More precisely, the device can be a second
- the taper of the first cutting tool is preferably less than the taper of the second. That is, the conical surface of the first tool has a smaller angle to the lower central axis than that of the second tool.
- Fig.l is a perspective view of a schematic
- Fig. 2 is a front view showing the distal end of said probe
- Fig. 3 is a partially cutaway perspective view of a cutting tool for common use with the probe of Figs. 1 and 2;
- Fig. 4 is a front view showing the distal end of said cutting tool
- FIG. 5 is a perspective view of the tool of FIG. 3 and 4;
- Fig. 6 is a partially cutaway perspective view of a second cutting tool for common use with the probe of Figs. 1 and 2 and the cutting tool of Figs. 3 to 5;
- Fig. 7 is a front view showing the distal end of said cutting tool
- FIG. 8 is a perspective view of the second cutting Tool shown in Figs. 6 and 7;
- Fig. 9 shows the probe and a cutting tool in use arrangement
- FIG 10 shows the probe and the second cutting tool in use arrangement.
- FIGS 1 to 10 show a possible embodiment of the device according to the present invention, which is shown only schematically, with reference to the most important parts.
- the device according to the invention comprises a probe 1 which has at least one channel 11, for example a guide channel 11 and / or an infiltration channel 111, or both, and a first and a second cutting tool 2, 3 which are concentric around the probe 1 are arranged.
- Each cutting tool 2, 3 has a distal end 21, 31, which is conical or frusto-conical in shape and has an inner opening 23, which surrounds the probe 1 in use.
- the conical regions 21, 31, 33 have numerous cutting edges, which run parallel to each other and helically.
- the geometry of the cutting edges (angle of attack, cutting edge and entry) are such that lateral cutting takes place. follows (cut to the left or cut to the right) according to techniques known in the field of industrial milling. In this way, the tool cuts only when it is rotated in a certain direction.
- the second cutting tool 3 has a larger outer diameter and also a greater conicity.
- the furthest distal point 22, 32 of the cutting tools 2, 3 is rounded.
- first the first cutting tool 2 is introduced, which thereby slides linearly along the probe, without any rotation in the cutting direction of the cutting tool.
- the conical shape promotes penetration without damaging the soft tissue. After hitting the bone tissue to be removed, the tool is rotated in the cutting direction.
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgical Instruments (AREA)
Abstract
La présente invention concerne un dispositif d'élimination de tissus osseux lors d'opérations endoscopiques, comprenant au moins un outil de coupe (2, 3) disposé de façon concentrique autour d'une sonde allongée (1), le dispositif se caractérisant en ce que l'outil de coupe présente une zone de coupe distale (21, 31) de géométrie conique, la surface distale conique présentant des arêtes de coupe latérales.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
ES200801552A ES2334622B1 (es) | 2008-05-26 | 2008-05-26 | Dispositivo para eliminacion de tejido oseo en operaciones endoscopicas. |
ESP200801552 | 2008-05-26 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2009152919A1 true WO2009152919A1 (fr) | 2009-12-23 |
Family
ID=41168782
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP2009/003672 WO2009152919A1 (fr) | 2008-05-26 | 2009-05-25 | Dispositif d'élimination de tissus osseux lors d'opérations endoscopiques |
Country Status (2)
Country | Link |
---|---|
ES (1) | ES2334622B1 (fr) |
WO (1) | WO2009152919A1 (fr) |
Cited By (33)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8394129B2 (en) | 2011-03-10 | 2013-03-12 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US8852243B2 (en) | 2011-03-10 | 2014-10-07 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US9277928B2 (en) | 2013-03-11 | 2016-03-08 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US9522070B2 (en) | 2013-03-07 | 2016-12-20 | Interventional Spine, Inc. | Intervertebral implant |
US9839530B2 (en) | 2007-06-26 | 2017-12-12 | DePuy Synthes Products, Inc. | Highly lordosed fusion cage |
US9883951B2 (en) | 2012-08-30 | 2018-02-06 | Interventional Spine, Inc. | Artificial disc |
US9895236B2 (en) | 2010-06-24 | 2018-02-20 | DePuy Synthes Products, Inc. | Enhanced cage insertion assembly |
US9913727B2 (en) | 2015-07-02 | 2018-03-13 | Medos International Sarl | Expandable implant |
US9931223B2 (en) | 2008-04-05 | 2018-04-03 | DePuy Synthes Products, Inc. | Expandable intervertebral implant |
US9993349B2 (en) | 2002-06-27 | 2018-06-12 | DePuy Synthes Products, Inc. | Intervertebral disc |
US9993353B2 (en) | 2013-03-14 | 2018-06-12 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US10058433B2 (en) | 2012-07-26 | 2018-08-28 | DePuy Synthes Products, Inc. | Expandable implant |
US10390963B2 (en) | 2006-12-07 | 2019-08-27 | DePuy Synthes Products, Inc. | Intervertebral implant |
US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
US10433977B2 (en) | 2008-01-17 | 2019-10-08 | DePuy Synthes Products, Inc. | Expandable intervertebral implant and associated method of manufacturing the same |
US10500062B2 (en) | 2009-12-10 | 2019-12-10 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
US10537436B2 (en) | 2016-11-01 | 2020-01-21 | DePuy Synthes Products, Inc. | Curved expandable cage |
US10548741B2 (en) | 2010-06-29 | 2020-02-04 | DePuy Synthes Products, Inc. | Distractible intervertebral implant |
US10888433B2 (en) | 2016-12-14 | 2021-01-12 | DePuy Synthes Products, Inc. | Intervertebral implant inserter and related methods |
US10940016B2 (en) | 2017-07-05 | 2021-03-09 | Medos International Sarl | Expandable intervertebral fusion cage |
US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
US11426286B2 (en) | 2020-03-06 | 2022-08-30 | Eit Emerging Implant Technologies Gmbh | Expandable intervertebral implant |
US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
US11452607B2 (en) | 2010-10-11 | 2022-09-27 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
US11510788B2 (en) | 2016-06-28 | 2022-11-29 | Eit Emerging Implant Technologies Gmbh | Expandable, angularly adjustable intervertebral cages |
US11596523B2 (en) | 2016-06-28 | 2023-03-07 | Eit Emerging Implant Technologies Gmbh | Expandable and angularly adjustable articulating intervertebral cages |
US11612491B2 (en) | 2009-03-30 | 2023-03-28 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
US11752009B2 (en) | 2021-04-06 | 2023-09-12 | Medos International Sarl | Expandable intervertebral fusion cage |
US11850160B2 (en) | 2021-03-26 | 2023-12-26 | Medos International Sarl | Expandable lordotic intervertebral fusion cage |
US11911287B2 (en) | 2010-06-24 | 2024-02-27 | DePuy Synthes Products, Inc. | Lateral spondylolisthesis reduction cage |
USRE49973E1 (en) | 2013-02-28 | 2024-05-21 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
US12004960B2 (en) | 2020-12-28 | 2024-06-11 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
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Cited By (88)
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---|---|---|---|---|
US9993349B2 (en) | 2002-06-27 | 2018-06-12 | DePuy Synthes Products, Inc. | Intervertebral disc |
US11273050B2 (en) | 2006-12-07 | 2022-03-15 | DePuy Synthes Products, Inc. | Intervertebral implant |
US10398566B2 (en) | 2006-12-07 | 2019-09-03 | DePuy Synthes Products, Inc. | Intervertebral implant |
US10583015B2 (en) | 2006-12-07 | 2020-03-10 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11712345B2 (en) | 2006-12-07 | 2023-08-01 | DePuy Synthes Products, Inc. | Intervertebral implant |
US10390963B2 (en) | 2006-12-07 | 2019-08-27 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11432942B2 (en) | 2006-12-07 | 2022-09-06 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11660206B2 (en) | 2006-12-07 | 2023-05-30 | DePuy Synthes Products, Inc. | Intervertebral implant |
US11497618B2 (en) | 2006-12-07 | 2022-11-15 | DePuy Synthes Products, Inc. | Intervertebral implant |
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US9839530B2 (en) | 2007-06-26 | 2017-12-12 | DePuy Synthes Products, Inc. | Highly lordosed fusion cage |
US10973652B2 (en) | 2007-06-26 | 2021-04-13 | DePuy Synthes Products, Inc. | Highly lordosed fusion cage |
US11622868B2 (en) | 2007-06-26 | 2023-04-11 | DePuy Synthes Products, Inc. | Highly lordosed fusion cage |
US11737881B2 (en) | 2008-01-17 | 2023-08-29 | DePuy Synthes Products, Inc. | Expandable intervertebral implant and associated method of manufacturing the same |
US10449058B2 (en) | 2008-01-17 | 2019-10-22 | DePuy Synthes Products, Inc. | Expandable intervertebral implant and associated method of manufacturing the same |
US10433977B2 (en) | 2008-01-17 | 2019-10-08 | DePuy Synthes Products, Inc. | Expandable intervertebral implant and associated method of manufacturing the same |
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US11612491B2 (en) | 2009-03-30 | 2023-03-28 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
US11607321B2 (en) | 2009-12-10 | 2023-03-21 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
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US10966840B2 (en) | 2010-06-24 | 2021-04-06 | DePuy Synthes Products, Inc. | Enhanced cage insertion assembly |
US11911287B2 (en) | 2010-06-24 | 2024-02-27 | DePuy Synthes Products, Inc. | Lateral spondylolisthesis reduction cage |
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US8597333B2 (en) | 2011-03-10 | 2013-12-03 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US8852243B2 (en) | 2011-03-10 | 2014-10-07 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
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US8394129B2 (en) | 2011-03-10 | 2013-03-12 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
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US11484420B2 (en) | 2011-03-10 | 2022-11-01 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US10729462B2 (en) | 2011-03-10 | 2020-08-04 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US11484419B2 (en) | 2011-03-10 | 2022-11-01 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US10182842B2 (en) | 2011-03-10 | 2019-01-22 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US11547442B2 (en) | 2011-03-10 | 2023-01-10 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US11547443B2 (en) | 2011-03-10 | 2023-01-10 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US11484418B2 (en) | 2011-03-10 | 2022-11-01 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US10058433B2 (en) | 2012-07-26 | 2018-08-28 | DePuy Synthes Products, Inc. | Expandable implant |
US9883951B2 (en) | 2012-08-30 | 2018-02-06 | Interventional Spine, Inc. | Artificial disc |
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ES2334622B1 (es) | 2011-01-03 |
ES2334622A1 (es) | 2010-03-12 |
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