WO2014126482A2 - Systèmes, appareil et procédés pour dissection de tissus - Google Patents

Systèmes, appareil et procédés pour dissection de tissus Download PDF

Info

Publication number
WO2014126482A2
WO2014126482A2 PCT/NZ2014/000015 NZ2014000015W WO2014126482A2 WO 2014126482 A2 WO2014126482 A2 WO 2014126482A2 NZ 2014000015 W NZ2014000015 W NZ 2014000015W WO 2014126482 A2 WO2014126482 A2 WO 2014126482A2
Authority
WO
WIPO (PCT)
Prior art keywords
biosensor
surgical tool
dock
tissue
tip
Prior art date
Application number
PCT/NZ2014/000015
Other languages
English (en)
Other versions
WO2014126482A3 (fr
Inventor
Paul Weber
Original Assignee
Paul Weber
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US13/767,876 external-priority patent/US10045761B2/en
Application filed by Paul Weber filed Critical Paul Weber
Priority to AU2014216758A priority Critical patent/AU2014216758A1/en
Priority to EP14752036.5A priority patent/EP2956066A4/fr
Priority to CN201480017956.0A priority patent/CN105188561B/zh
Priority to GB1514773.9A priority patent/GB2525800A/en
Priority to BR112015019449A priority patent/BR112015019449A2/pt
Publication of WO2014126482A2 publication Critical patent/WO2014126482A2/fr
Publication of WO2014126482A3 publication Critical patent/WO2014126482A3/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/0045—Devices for taking samples of body liquids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14503—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14507—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue specially adapted for measuring characteristics of body fluids other than blood
    • A61B5/1451—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue specially adapted for measuring characteristics of body fluids other than blood for interstitial fluid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0048—Detecting, measuring or recording by applying mechanical forces or stimuli
    • A61B5/0051—Detecting, measuring or recording by applying mechanical forces or stimuli by applying vibrations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0071—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by measuring fluorescence emission
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0075—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/01—Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14539—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring pH
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14542—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring blood gases
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14546—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring analytes not otherwise provided for, e.g. ions, cytochromes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1495—Calibrating or testing of in-vivo probes

Definitions

  • FIG. 1a is a perspective view of an embodiment of a tissue dissector (TD) with a sensor dock on the upper side of the device with the cover removed showing a dock with sensor. .
  • TD tissue dissector
  • FIG. 1b is a perspective view of a break-away portion of the embodiment previously depicted in FIG.
  • FIG. 1c is a perspective view of the embodiment previously depicted in FIG. 1a with the cover retracted revealing a dock and sensor.
  • FIG. 1d is a perspective view of a break-away portion of the embodiment previously depicted in FIG. 1c dissector wherein the cover is retracted.
  • FIG. 1e is a perspective view of the embodiment previously depicted in FIG. 1a with the cover closed thereby covering and sealing the dock.
  • FIG. 1f is a perspective view of a break-away portion of the embodiment previously depicted in FIG. 1e wherein the cover is closed over the dock.
  • FIG. 1g is a cross sectional view of an embodiment of a cover comprising a protrusion and a groove.
  • FIG. 1h is a cross sectional view of an embodiment of a dock comprising a protrusion and a groove.
  • FIG. 1i is a side view of the embodiment previously depicted in FIG. 1a of a TD illustrating an example of positioning a sensor at an angle different from the shaft axis.
  • FIG. 1j is a side view of the embodiment previously depicted in FIG. 1a of a TD illustrating an example of positioning a sensor at an angle substantially parallel to the shaft axis.
  • FIG. 1k is a side view of an alternative embodiment of a TD, in which the cover comprises openings.
  • FIG. 1 L is a side view of an alternative embodiment of a TD, in which the cover comprises openings and a portion of the sensor protrudes through the openings.
  • FIG. 2a is a perspective view of an embodiment of a tissue dissector (TD) with a sensor dock on the upper side of the device with the cover removed showing a dock with a sensor.
  • TD tissue dissector
  • FIG. 2b is a perspective view of a break-away portion of the embodiment previously depicted in FIG.
  • Fig. 2bb is a perspective view of a break-away portion of an alternative embodiment of a TD, in which the shaft separates revealing a dock.
  • FIG. 2c is a perspective view of the embodiment previously depicted in FIG. 1a with the cover retracted revealing a dock and sensor.
  • FIG. 2d is a perspective view of a break-away portion of the embodiment previously depicted in FIG. 2c dissector wherein the cover is retracted.
  • FIG. 2e is a perspective view of the embodiment previously depicted in FIG. 2a with the cover closed thereby covering and sealing the dock.
  • FIG. 2f is a perspective view of a break-away portion of the embodiment previously depicted in FIG. 2e wherein the cover is closed over the dock.
  • FIG. 2g is a cross sectional view of an embodiment of a cover comprising a protrusion and a groove.
  • FIG. 2h is a cross sectional view of an embodiment of a dock comprising a protrusion and a groove.
  • FIG. 2i is a side view of the embodiment previously depicted in FIG. 2a of a TD illustrating an example of positioning a sensor at an angle different from the shaft axis.
  • FIG. 2j is a side view of the embodiment previously depicted in FIG. 2a of a TD illustrating an example of positioning a sensor at an angle substantially parallel to the shaft axis.
  • FIG. 2k is a side view of an alternative embodiment of a TD, in which the cover comprises openings.
  • FIG. 2L is a side view of an alternative embodiment of a TD, in which the cover comprises openings and a portion of the sensor protrudes through the openings.
  • FIG. 3a is a perspective view of an embodiment of a tissue dissector (TD) with a sensor dock on the upper side of the device with the cover removed; this embodiment lacks tip protrusions or lysing segments.
  • TD tissue dissector
  • FIG. 3b is a perspective view of a break-away portion of the embodiment previously depicted in FIG.
  • FIG.3bb is a perspective view of a break-away portion of the embodiment previously depicted in FIG. 3a wherein the dock may be positioned within the shaft or tip and may be exposed when adjacent portions of the shaft or tip may be separated telescopically.
  • FIG. 3c is a perspective view of the embodiment previously depicted in FIG. 3a with the cover retracted revealing a dock and sensor.
  • FIG. 3d is a perspective view of a break-away portion of the embodiment previously depicted in FIG. 3c dissector wherein the cover is retracted.
  • FIG. 3e is a perspective view of the embodiment previously depicted in FIG. 3a with the cover closed thereby covering and sealing the dock.
  • FIG. 3f is a perspective view of a break-away portion of the embodiment previously depicted in FIG. 3e wherein the cover is closed over the dock.
  • FIG. 3g is a cross sectional view of an embodiment of a cover comprising a protrusion and a groove.
  • FIG. 3h is a cross sectional view of an embodiment of a dock comprising a protrusion and a groove.
  • FIG. 3i is a side view of the embodiment previously depicted in FIG. 3a of a TD illustrating an example of positioning a sensor at an angle different from the shaft axis.
  • FIG. 3j is a side view of the embodiment previously depicted in FIG. 3a of a TD illustrating an example of positioning a sensor at an angle substantially parallel to the shaft axis.
  • FIG. 3k is a side view of an alternative embodiment of a TD, in which the cover comprises openings.
  • FIG. 3L is a side view of an alternative embodiment of a TD, in which the cover comprises openings and a portion of the sensor protrudes through the openings.
  • FIG. 4a is a side view of a robotic surgery system comprising a TD
  • FIG. 4b depicts an alternative robotic arm that may be used with the system of FIG. 4a.
  • FIG. 5a is an upper plan view illustrating the protrusions and lysing segments of an embodiment of a tissue dissector, wherein some of the protrusions and lysing segments are oriented in a non-axial direction.
  • FIG. 5b is an upper plan view illustrating the protrusions and lysing segments of an alternative embodiment of a tissue dissector, wherein some of the protrusions and lysing segments are oriented in a non-axial direction.
  • FIG. 5c is an upper plan view of an alternative embodiment of a tissue dissector, wherein some of the protrusions and lysing segments are oriented in a non-axial direction.
  • FIG. 5d is a lower plan view of an alternative embodiment of a tissue dissector, wherein some of the protrusions and lysing segments are oriented in a non-axial direction and an antenna is present.
  • FIG. 6 is a flow chart illustrating one implementation of a method of a method of use for the apparatus depicted in Figures 1 a-j for tissue/fluid sampling and/or analysis.
  • FIG. 7 is a flow chart illustrating one implementation of a method for accessing an organ with the 90 assistance of a TD.
  • FIG. 8 is a flow chart illustrating an implementation of a method for sampling and/or testing tissue
  • FIG. 9 is a flow chart illustrating an implementation of a method comprising detection functionality.
  • FIG.10 depicts an embodiment comprising a modular, removable tip and a flexible shaft.
  • FIG. 11 depicts an embodiment comprising a shaft having a flexible segment and a rigid segment.
  • Some 'Labs on Chips' may include nanosensors and optic sensors; however, their placement and/or use inside a living creature may present a different environment than that of a laboratory benchtop. Perhaps mimicking and/or modulating a small-scale environment external to a 'Lab on a Chip' by housing and/or docking chip(s) in various manners, in/on probes, chip function and/or use may be facilitated.
  • dissection may indicate the separation of tissues or of one tissue plane from another (ref:
  • a lobe of a human liver has a radius of curvature of about 5cm; however, compared to a surgical instrument of about 1cm in width capable of separating tissue in a plane, the curvilinear plane comprising the liver lobe may be 'substantially' planar and thus amenable to a tool capable of separating tissues in a 'substantially planar' fashion.
  • 'minimally invasive surgery has been used to describe a procedure (surgical or otherwise) that is less invasive than open surgery used for the same purpose.
  • Some minimally invasive procedures typically involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device, and are carried out through the skin or through a body cavity or anatomical opening. This may result in shorter hospital stays, or allow
  • TDM Tissue Dissecting and Modifying Wand
  • the senor 135 may therefore be incorporated on or near the energy windows to allow a surgeon to heat the tissue to a desired temperature or within a desired temperature range.
  • the sensor may be configured to provide an average temperature over a particular period of time and or over a particular range of distances within the tissue.
  • Systems consistent with the disclosure provided herein may be configured to prevent or to shut down or otherwise limit energy transfer if a particular tissue temperature were beyond a
  • biosensors for detecting and/or analyzing a biological analyte.
  • biosensors may comprise, for example, one or more sensitive biological elements, such as tissue, microorganisms, enzymes, antibodies, nucleic acids, etc.
  • biosensors may also comprise a transducer.
  • Systems comprising surgical tools comprising such
  • biosensors may also comprise an electronic system comprising, for example, a signal amplifier, processor, and display to compile and/or display information from the biosensor.
  • biosensors that may be useful in connection with one or more embodiments disclosed herein include nanobiosensors, optical biosensors, electrochemical biosensors, piezoelectric biosensors, electronic biosensors, gravimetric biosensors, and pyroelectric biosensors.
  • one or more radiation detecting sensors may be provided.
  • such radiation detectors may be configured to detect all species of radiation, including beta particles, gamma rays, x-rays, alpha particles, and neutrons.
  • the radiation sensor(s) may be positioned within a dock on a surgical tool. Such dock, as described elsewhere herein, may be configured to be sealed with a cover. As such, a gas, such as
  • 155 as an electrically biased gas, may be introduced into the dock with the cover in a closed position.
  • gas or gasses may be introduced by a fluid port also positioned within the dock. Radiation within a patient's body may then be detected by way of interaction with tailored nanoparticles, which may release secondary charged particles that ionize the gas within the dock.
  • the ionized gas may then be withdrawn from the dock by way of, for example, a fluid extraction port,
  • Such analysis may comprise collection of ionized particles on biased electrodes, which may result in a characteristic electrical signal that may be detected to indicate the detection of one or more forms of radiation.
  • the electrodes used for this analysis may also be provided within the dock and the resulting signal may be transmitted electronically (wired or wirelessly) outside of the patient's body for
  • the signal may also be processed on the device and the resulting data stored on a local storage medium.
  • Examples of radiation detection systems and techniques that may be useful for one or more embodiments disclosed herein may be found in "A Nanoparticle Doped Micro-Geiger Counter for Multispecies Radiation Detection," Journal of Microelectromechanical Systems, Volume 18, Issue 5, pp. 998-1003 (Oct. 2009), which article is hereby incorporated by reference in its entirety.
  • Examples of other sensors that may be provided with one or more embodiments disclosed herein include electromagnetic sensors, electrical sensors, and temperature sensors.
  • electromagnetic sensors may include colorimeter, electro-optical sensor, infrared sensor, photodetector, fiberoptic sensor, and/or LEDs as sensors, etc.; also LEDs can be multiplexed in such a circuit, such that it can be used for both light emission and sensing at different times.
  • electrical sensors may include colorimeter, electro-optical sensor, infrared sensor, photodetector, fiberoptic sensor, and/or LEDs as sensors, etc.; also LEDs can be multiplexed in such a circuit, such that it can be used for both light emission and sensing at different times.
  • electrical sensors may
  • thermosensor 175 include oxygen sensor, C02 sensor, pH glass electrode, and/or a current sensor, etc.
  • thermal sensors may include Infrared thermometer, resistance temperature detector, resistance temperature detector, resistance thermometer, thermistor, thermocouple, thermometer, etc.
  • Temperature sensors that may be useful in connection with embodiments disclosed herein include, but are not limited to, resistance temperature sensors, such as carbon resistors, film thermometers, wire-
  • thermometers 180 wound thermometers, or coil elements.
  • Some embodiments may comprise thermocouples, pyrometers, or non-contact temperature sensors, such as total radiation or photoelectric sensors.
  • one or more temperature sensors may be coupled with a processor and/or a monitor to allow a surgeon to better visualize or otherwise control the delivery of energy to selected areas of target tissue.
  • some embodiments may be configured such that a surgeon can visualize the temperature of tissue
  • Some embodiments may alternatively, or additionally, be configured such that one or more temperature sensors are coupled with a processor in a feedback loop such that energy delivery may be automatically adjusted by the system in response to temperature data. For example, when temperatures exceed a particular threshold, such as somewhere between about 65° C and about 90° C,
  • the system may be configured to shut down or otherwise limit further energy delivery.
  • the threshold may be between about 68° C and about 75° C.
  • Some embodiments may comprise a feedback means, such as a visual, audible, or tactile feedback means, to provide information to a user to avoid excess energy delivery to tissues.
  • the feedback means may be configured to notify the surgeon when the temperature has reached a
  • the feedback means may be configured to notify the surgeon when the TD has been positioned in a particular location within the target region for a particular time period.
  • visual feedback means include LED lights, LASERS, visual light source, display screen, etc.
  • audible feedback means include speakers, alarms, audible vibration, etc.
  • tactile feedback means include vibration, minimal electrical shock, heat, etc.
  • the feedback means may be
  • the TD may be configured to deliver a first noise and at a second threshold the TD may be configured to deliver a second noise.
  • the second noise may be louder than the first noise to indicate a greater urgency for changing the energy delivery and/or moving the TD from its current location within a patient's body.
  • an antenna(s) may be present on the shaft or tip of the TD.
  • a camera or fiberoptic may gather optical data to allow the surgeon knowledge of the placement of the TD.
  • Tissue Dissector is intended to encompass any of the devices for dissecting tissue disclosed herein including Tissue Dissecting and Modifying Wands (TDM) comprising lysing segments and tissue dissecting wands lacking lysing segments.
  • TDM Tissue Dissecting and Modifying Wands
  • the term 'modifying' in this context may refer to or may encompass application of energy to tissue using one or more lysing segments as discussed herein.
  • the term 'modifying' in this context may also refer to application of energy to tissue by way of an energy window as also described herein.
  • FIGS. 1a-j depict various views of a particular embodiment of a tissue dissector (TD) with a sensor
  • FIG. 1a is a perspective view of an embodiment of a TD comprising a tip 101, a shaft 102 and a handle 103.
  • dock 184 Located on the shaft is dock 184 that may accommodate seat 188 which may releasably hold sensor 189.
  • sensor 189 may comprise a nanosensor.
  • dock 184 may be recessed into shaft 102 and/or tip 101. In some embodiments dock 184 may protrude from shaft
  • sensor 189 may comprise a silicon nanowire sensor. In some embodiments the sensor 189 may comprise a biological nanosensor. In some embodiments, nanosensor 189 may comprise a conducting polymer and/or glass and/or polymer and/or plastic and/or graphene and/or carbon, etc.. In some embodiments, seat 188 may be fixed in position. In some embodiments, seat 188 may be moveable.
  • sensor 184 may be fixed in seat 188.
  • the sensor 189 may be detachable seat 188. It is contemplated that in alternative embodiments, seat 188 may be omitted.
  • the dock may comprise cover moving means and/or a cover tip. Cover tip 181 and means for selectively moving a cover 183 may be positioned adjacent dock 184. Examples of such cover moving means may include rails, grooves, tracks, ratchets, cables, arms, lines, etc. In the depicted
  • the cover moving means comprises a rail.
  • a portion of the shaft may comprise cover moving means 183. It is contemplated that in alternative embodiments, cover moving means 183 may be omitted.
  • Dock 184 may comprise one or more dock wall(s) 185.
  • Dock wall 185 may comprise fluid delivery port 186 for fluid delivery conduit.
  • Dock wall 185 may comprise fluid extraction port 187 for fluid extraction conduit.
  • Fluid delivery port 186 may, in some embodiments, be configured to deliver
  • a gas such as a low-humidity gas, a noble gas, and/or other gases that may be useful for drying out dock
  • fluid extraction port 187 may be used to remove gases from dock 184 so as to allow for desired circulation of such gases within dock 184.
  • dock wall 185 may comprise one or more ports 186 and/or 187.
  • cover 180 is moveable along cover moving means 183 and may be opened or closed via internal
  • cover 240 control wires.
  • the cover may be moved by motors.
  • Rear end of cover 182 may be fixed to cover 180.
  • rear end of cover 182 is not fixed to cover and is itself attached to another portion of the TD.
  • dock 184 and/or dock wall 185 may accommodate a temperature modification means 195 for modifying a temperature within the dock 184 and cover 180.
  • Temperature modification means 195 may comprise, for example a heater, a Peltier cooler, a heat pump,
  • Temperature modification means 195 may be used to heat fluids introduced by way of port 186.
  • Temperature modification means 195 may alternatively be used to heat tissues and/or other fluids such as body tissues and/or fluids captured during a procedure using the TD. In some embodiments temperature modification means 195 may facilitate and/or inhibit certain chemical reactions and/or bond alterations that may be needed in order to sense certain biomaterials using sensor 189. In some embodiments, dock 184
  • temperature modification means 195 may comprise an electrical resistance heater.
  • heater 195 may comprise a thin film resistor and/or piezoelectric heating device and/or other device capable of heating fluids.
  • mixing element 196 may comprise a propeller driven by an electric motor.
  • mixing element 196 may comprise one or more flaps of relatively
  • mixing element 196 may comprise an unattached stirring rod spun by oscillating magnet.
  • a separate set of ports may originate and terminate in dock 184, and may be connected by conduit which is fluidly coupled with a piezoelectric pump and/or another fluidic motor and/or another fluidic driving device.
  • such port(s) may be positioned at an opposite end of dock 184 such that delivery of fluid(s) and/or application of a vacuum may be applied more evenly throughout dock 184. It is contemplated that in alternative embodiments, temperature modification means 195 and/or mixing element 196 may be omitted.
  • One or more sensors 178 and/or 179 may be located on dock 184. In some embodiments, one or more sensors 178 and/or 179 may be located on dock wall 185
  • Sensors 178 and/or 179 may comprise any of the specific examples of sensors discussed in connection with sensors 110 and/or 114. Sensor(s) 178 and/or 179 may report conditions and/or changing conditions in dock area 184 in and/or around nanosensor 189.
  • Nanosensors may be obtained/manufactured by methods available to those of ordinary skill in the art, including but not limited to: U.S. Patent No. 8,022,444 B2 titled "Biosensor and Method of Manufacturing
  • Patent No. 8,236,595 B2 titled “Nanowire Sensor, Nanowire Sensor Array and Method of Fabricating the Same," and/or Label Free DNA Sensor Using a Silicon Nanowire Array (Kulkarni, Xu, Ahn, Amin, et.al.; J Biotechnol, 2012, Aug 31 ;160(3-4):91-6.) and/or Conducting Polymers: An Emerging Field of Biosensors (Borole, DD et al.; Des Monomers Polymers, 2006 9(1): p. 1-11.) and/or Conducting Polymers for DNA
  • reagents and/or chemicals and/or biochemicals may be present in and/or delivered to and/or removed from the dock area to facilitate sensor use and/or cleaning, etc., may
  • 305 include but not be limited to ethanolic solutions, thiols, SDS (sodium dodecyl sulfate), water, argon gas, sodium chloride, sodium bicarbonate buffer, EGTA (ethylene glycol tetraacetic acid), EDTA (ethylenediaminetetraacetic acid), sulfo-NHS diazirine (sulfo-SDA), PBS (phosphate buffered saline), and/or Tween®-20 (PBST), etc.
  • EGTA ethylene glycol tetraacetic acid
  • EDTA ethylenediaminetetraacetic acid
  • sulfo-NHS diazirine sulfo-SDA
  • PBS phosphate buffered saline
  • Tween®-20 Tween®-20
  • Nanoparticle Probes (TATON, MIRKIN, LESTINGER; Science, 8 Sept 2000, vol.289, no 5485, pp1757- 1760.); Detection of Methicillin-Resistant Staphylococcus aureus (MRSA) using the NanoLantern Biosensor (STROHSAHL, MILLER, KRAUSS; Proc. of SPIE, Vol 71670S pp. 1-12.); Ultrasensitive and Selective Multiplexing Detection of Cancer Markers Using Nanowire Nanosensors (CIU, WANG, HUYNH, LIEBER; Harvard University, pp 1-21.); Field Effect Transistor Nanosensor for Breast Cancer Diagnostics
  • sensor 178 and or sensor 179 may comprise a camera. In some embodiments, sensor 178 and or sensor 179 may comprise a fiberoptic and/or fiberoptic camera and/or CCD camera and/or other camera.
  • one or more electromagnetic delivery elements 177 may be positioned on dock 184 tip and/or cover 180 and/or tip of cover 181.
  • Other embodiments may comprise one or more electromagnetic delivery elements on any other suitable location on the TD, including but not limited to on the sensor 189 or otherwise on seat 188.
  • Electromagnetic delivery elements that may be useful include but are not limited to: LEDs, LASERs, fiberoptics, filaments, photoelectric materials, infrared emitters, etc.
  • emission of such electromagnetic energy may be absorbed by a chemical and/or biomolecule on the sensor and/or dock area and/or reflectance and/or emission spectra of the chemical and/or biomolecule and/or a further product may be detected via sensors 178 and/or 179.
  • seat 188 may be configured to seal, or at least substantially seal, one or more portions of one or more sensors positioned on seat 188.
  • seat 188 may comprise
  • the skirt may comprise a flexible material, such as a plastic or rubber material, to allow the sensor to be positioned therein and seal the perimeter in order to, for example, prevent fluids from reaching certain portions of the sensor, such as a lower surface of the sensor.
  • the seat may be configured with an opening through which the sensor may extend.
  • a portion of the sensor may be positioned below the opening and a portion of the sensor, such as a portion configured to interact with biological tissues and/or fluids, may extend above the seat.
  • the sensor may be configured in such embodiments to be secured underneath the seat opening by, for example, snap-fit engagement, friction fit, threaded coupling, bayonet clamp, etc.
  • such opening may be configured to automatically seal around the
  • cover 180 and/or dock 184 may be configured to reflect electromagnetic radiation. Reflecting electromagnetic radiation and/or having mirror-like properties may allow for detection of electromagnetic radiation by sensors 178 and/or 179. In some embodiments, cover 180 and/or dock 184
  • cover 180 and/or dock 184 comprise a coating of aluminum.
  • the aluminum coating comprises a protected aluminum and/or enhanced aluminum and/or UV-enhanced aluminum (a maker may be Edmund Optics, Barrington, NJ, USA).
  • cover 180 may comprise plastic. In other embodiments cover 180 may comprise materials including but not limited to: polymers, quartz, glass, carbon based materials, silicates and/or metals.
  • the conduit may also contain electrical control wires to aid in device operation. Partially hidden from direct view in FIGS. 1a & 1 b, and located in the grooves defined by protrusions 104 are electrically
  • conductive tissue lysing elements 105 which, when powered by an electrosurgical generator, effects lysing of tissue planes on forward motion of the device.
  • the lysing segments may be located at the termini of conductive elements.
  • one or more sensors such as for example sensors 110 and 114 may be positioned on the device.
  • the sensors 110 and 114 may comprise any of the sensors described in the specification herein.
  • sensor 110 and or sensor 114 may comprise a
  • sensor 110 and or sensor 114 may comprise a fiberoptic and/or fiberoptic camera and/or CCD camera and/or other camera.
  • Other embodiments may comprise one or more sensors on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft. Sensors that may be useful include thermal sensors, photoelectric or photo optic sensors, cameras, etc.
  • one or more sensors may be used to monitor the local post
  • Some embodiments may also comprise one or more sensors incorporating MEMS (Micro Electro- Mechanical Systems) technology, such as MEMS gyroscopes, accelerometers, and the like. Such sensors may be positioned at any number of locations on the TD, including within the handle in some embodiments.
  • sensor 114 may comprise fiberoptic elements. In an embodiment, the sensor can
  • the temperature sensor 375 be configured to sense a temperature of tissue adjacent to the apparatus.
  • the temperature sensor may alternatively be configured or sense a temperature of one or more fluids adjacent to the apparatus such as for example tissue fluids and/or fluids introduced by the surgeon.
  • Temperature and impedance values may be tracked on a display screen or directly linked to a microprocessor capable of signaling control electronics to alter the energy delivered to the tip when preset
  • Typical instrumentation paths are widely known, such as thermal sensing thermistors, and may feed to analog amplifiers which, in turn, feed analog digital converters leading to a microprocessor.
  • internal or external ultrasound measurements may also provide information which may be incorporated into a feedback circuit.
  • an optional mid and low frequency ultrasound transducer may also be activated to transmit energy to the tip and
  • a flashing visible light source for example, an LED
  • can be mounted on the tip may show through the tissues and/or organs to identify the location of the device.
  • one or more electromagnetic delivery elements 115 may be positioned on tip or shaft.
  • Other embodiments may comprise one or more electromagnetic delivery elements on any other
  • Electromagnetic delivery elements that may be useful include: LEDs, LASERs, fiberoptics, filaments, photoelectric materials, infrared emitters, etc.
  • handle 103 may comprise one or more ports through which various conduits may be passed.
  • a plurality of conduits may be bundled together for
  • an energy delivery conduit bundle 198 may be provided, which may comprise a lysing segment energy conduit 111 and an energy window conduit 112.
  • a miscellaneous conduit bundle 199 may be provided.
  • Miscellaneous conduit bundle 199 may comprise, for example, various other conduits, such as conduits for one or more sensors, such as sensors 110 and 114, one or more electromagnetic delivery elements 115, fluid delivery port(s) 116, and/or
  • miscellaneous conduit bundle 199 may comprise one or more additional conduits, such as one or more additional fluid delivery conduits for delivering a fluid, such as a liquid or gas, to port 186 in dock 184 in the TD.
  • Miscellaneous conduit bundle 199 may further comprise one or more fluid extraction conduits (from port 187 in dock 184) for extracting of fluid to direct the fluid (again, a liquid or gas) to a remote fluid/chemical sensor.
  • the fluid delivery conduit (leading to port 186) may be configured to deliver, for example, buffers, cleansers, quenching agents, reagents, biological compounds, inert compounds, gases. Fluids delivered (by way of a fluid delivery conduit leading to port 186) may be energized, such as heated, ultrasonically energized, may contain detergents, antibodies, drugs, etc.
  • Fluid extraction conduits (leading from port 187) may not only be used to withdraw fluids to be
  • Fluid extraction conduit leading from port 187) may also be used to extract fluids for external analysis. Some embodiments may be configured to provide a bubble between separate sets of fluids to allow a user to distinguish between various fluid streams delivered using fluid extraction
  • a vibration means 170 may be positioned in the handle.
  • Other embodiments may comprise one or more vibration means on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • suitable vibration means may include piezoelectric materials, ultrasonic motors with stators, piezoelectric actuators, vibration motor
  • vibration means such as an off-center weight mounted on a gear, etc.
  • Some vibration means may be configured to emit ultrasound in the 20-40kHz range.
  • Yet other vibration means may include electromagnet drivers with a frequency of operation in the range of 150-400Hz.
  • one or more vibration means may be used to provide additional forces which may facilitate passage of the TD.
  • one or more vibration means may be used to reduce debris on the electrosurgical or other components of
  • a vibration means may be directly or indirectly connected to one or more of the lysing segments. Some vibration means may help to decrease and/or remove debris. In some embodiments use of a vibration means may, also or alternatively, be used to assist in migrating the TD through tissue during the procedure. In some such embodiments, it is thought that use of a vibration means having a lower frequency may be particularly useful for assisting in such migration. In addition,
  • positioning the vibration means closer to a handle of the TD may facilitate such migration as well.
  • positioning the vibration means on or near the tip, and/or using a higher frequency vibrations means may be particularly useful for preventing buildup of debris on the tip.
  • Figures 1 d, c depict the TD with cover 180 moved proximally to expose dock.
  • Figures 1 f, e depict the TD with cover 180 moved distally to close over and/or seal dock.
  • FIG. 1g is cross sectional view of an embodiment of cover 180 comprising a groove 191 and projection
  • Groove 192 may be used to direct fluids within cover 180 to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations and/or bringing fluids of with a temperature range to locations within the dock or cover.
  • projection 192 may also be used to direct fluids to one or more desired locations and/or
  • FIG. 1 h is cross sectional view of an embodiment of dock 184 comprising a groove 193 and a projection 194 as described herein.
  • Groove 193 may be used to direct fluids within dock 184 to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations and/or bringing fluids of with a temperature range to locations within the dock or cover.
  • projection 194 may also be used to direct fluids to one or more desired locations and/or agitate fluids in a desired manner for a particular use.
  • cover 180 and dock 184 may when cover 180 is in a closed position, define a common space.
  • cover grooves 191 may operate in conjunction with dock grooves 193 or dock protrusions 194 to impact fluid behavior in a desired manner.
  • one or more grooves 191 and 193 may be provided for example in dock 184 and/or in an interior surface of cover 180 in order to direct fluids delivered through port 186 are directed to desired to one or more desired locations.
  • grooves may be configured to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations.
  • One or more projections 192 and 194 may be provided for example in dock 184 and/or in an
  • projections may be configured to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations.
  • multiple projections may define a groove, in other embodiments one or more grooves may be formed within a surface of a cover and/or dock.
  • closure cover 180 may also facilitate isolation of biological tissues and/or fluids.
  • closure of cover 180 may allow for analysis of tosses and/or fluids while preventing contamination by other such tissues and fluids after a sample has been taken. Cleaning may be further facilitated by positioning of the seat and/or sensors at an angle and/or various angles.
  • 465 configuration depicted in Figure 1 i may be primarily for facilitating capture to tissue and/or fluids for analysis, however some embodiments may be configured to tilt seat 188 toward a rear portion of the TD such that it faces (tilts toward) fluid port 186 to facilitate cleaning of sensor 189.
  • Fluid delivery port 186 for fluid delivery and fluid extraction port 87 for fluid extraction may also serve to deliver and/or remove fluids, for example, including but not limited to reagents and/or analyte(s) and/or
  • fluid delivery from fluid delivery port 186 and/or fluid extraction from fluid extraction port 187 may be linked in a circuit with a pump and/or additional conduit (that is coupled with one or both of the conduits coupled with fluid delivery port 186 and fluid extraction port 187) to recirculate and/or heat and/or incubate and/or mix and/or add reagents and/or remove reagents and/or other materials from the space within the cover 180 and/or dock 184.
  • a pump and/or additional conduit that is coupled with one or both of the conduits coupled with fluid delivery port 186 and fluid extraction port 187) to recirculate and/or heat and/or incubate and/or mix and/or add reagents and/or remove reagents and/or other materials from the space within the cover 180 and/or dock 184.
  • a pump and/or additional conduit that is coupled with one or both of the conduits coupled with fluid delivery port 186 and fluid extraction port 187) to recirculate and/or heat and/or incubate
  • the available space for fluids between the cover 180 and dock 184 may be derived by measuring an amount of fluid entering and/or exiting from ports 186 and/or 187 via their conduits. Such measurements may be compared with CAD (Computer Aided Design) calculations of the space.
  • CAD Computer Aided Design
  • Fig. 1 i is a side (break away) side view, of of the embodiment previously depicted in FIG. 1a of a TD, illustrating an example of positioning and/or protruding a seat (containing a nanosensor) that may allow for some exposure to passing tissues or fluids.
  • the TD may comprise an actuator 190.
  • actuator 190 may comprise a motor.
  • actuator 190 may comprise one or more such motors such as a screw-drive motor, gear motor, hydraulic motors etc.
  • actuator 190 may comprise one or more such motors such as a screw-drive motor, gear motor, hydraulic motors etc.
  • actuator 190 may comprise worm gearheads, motor control circuits, monitors, remote control devices, etc.
  • actuator 190 may be controlled or moved by wire and/or spring.
  • actuator may be controlled or moved by wire using manual work.
  • actuator 190 may be omitted.
  • seat 188 may be configured to be manually actuated or tilted.
  • seat 188 may be configured to be positioned in affixed number of angles relative to shaft
  • seat 188 may be configured to be repositioned in an infinite number of angled positions relative to shaft 102 and/or dock.
  • Means for delivering ultrasonic energy 197 may be located in/on in/on dock wall 185 of dock 184.
  • Ultrasonic means 197 may be configured to for example, heat fluids: aid in the cleaning of one or more portions of the TD including for example dock 184: aid in the mixing of reagents and/or organic chemicals
  • the ultrasonic means comprises a piezoelectric ceramic.
  • the piezoelectric ceramic may measure about 2mm x 2mm x 4mm. It is contemplated that in alternative embodiments, ultrasonic means 197 may be omitted. In some embodiments the piezoelectric ceramic is
  • the piezoelectric may comprise quartz and/or barium titanate and/or film polymer polyvinylidene fluoride.
  • the ultrasonic means measures between 1 mm and 20mm in any dimension.
  • Some embodiments may 505 comprise a plurality of ultrasonic means.
  • ultrasonic means may be configured to be positioned on two or more intersecting surfaces, for example in the embodiment depicted in Fig.
  • a portion of ultrasonic means 197 is positioned on an upper surface of shaft 102 and a second portion of ultrasonic means 197 is positioned along dock wall 185 which intersects the upper surface of shaft 102.in the depicted embodiment wall 185 intersects the top surface of shaft 102 at a substantially perpendicular
  • positioning the seat 188 and/or sensors 189 at one or more angles while the cover is in the open position may allow sensor(s) 189 to increase and/or alter contact and/or friction to facilitate a desired reaction between sensor 189 passing tissues and/or fluids.
  • substantially parallel angle with shaft 102 may be desirable or at least suitable for some applications.
  • one or more suction/vacuum ports 117 may be provided on or about the tip or distal shaft.
  • the port(s) may be fluidly coupled with a vacuum; the vacuum may comprise a pump or a negative pressure chamber or a syringe at the end of a fluid conduit.
  • Other embodiments may comprise one or more suction/vacuum ports on any other suitable location on the TD, including but not limited to on
  • a fluid delivery port 116 may be provided.
  • the fluid delivery port may be coupled with a pump or high pressure fluid.
  • the port may be perpetually open such that fluid may be delivered therethrough upon actuation of a pump or fluid pressure system.
  • the port may be closed and selectively opened to deliver fluid therethrough.
  • Other embodiments may comprise one or
  • Fluid ports on any other suitable location on the TD including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • Fluid ports that may be useful may comprise channels within the TD, polymer lines, hoses, etc.
  • Fluids that may emanate from the outlet may comprise ionic fluids such as saline, medicines (including but not limited to antibiotics, anesthetics, antineoplastic agents, bacteriostatic agents, etc.), non-ionic fluids, and or gasses (including but not limited to nitrogen, argon, air, etc.).
  • ionic fluids such as saline, medicines (including but not limited to antibiotics, anesthetics, antineoplastic agents, bacteriostatic agents, etc.), non-ionic fluids, and or gasses (including but not limited to nitrogen, argon, air, etc.).
  • fluids may be under higher pressures or sprayed. It should be understood that although these elements (116 & 117) are not depicted in every one of the other figures, any of the embodiments described herein may include one or more such elements.
  • 118 represents an antenna, such as an RFID TAG or Bluetooth antenna configured to deliver a signal to a receiver unit.
  • antenna 118 comprises an RFID
  • the RFID tag may comprise an RFID transponder.
  • the RFID tag may comprise a passive tag.
  • antenna 118 is not depicted in every one of the other figures, any of the embodiments described herein may comprise one or more such elements.
  • Other embodiments may comprise one or more antenna(s) on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft. In embodiments wherein antenna(s) 118
  • transponder such transponder may comprise a microchip, such as a microchip having a rewritable memory.
  • the tag may measure less than a few millimeters.
  • a reader may generate an alternating electromagnetic field which activates the antenna, such as an RFID transponder, and data may be sent via frequency modulation.
  • the position(s) of the RFID tag(s) or other antenna may be
  • the position may be related to a 3 dimensional mapping of the subject.
  • the reader may generate an alternating electromagnetic field.
  • the alternating electromagnetic field may be in the shortwave (13.56MHz) or UHF (865-869 Hz) frequency. Examples of potentially useful systems and methods for mapping/tracking a surgical instrument in relation to a patient's body may be found in U.S.
  • a transmission unit may be provided that may generate a high-frequency electromagnetic field configured to be received by an antenna of the RFID tag or another antenna.
  • the antenna may be configured to create an inductive current from the electromagnetic field. This current may
  • 555 activate a circuit of the tag, which may result in transmission of electromagnetic radiation from the tag. In some embodiments, this may be accomplished by modulation of the field created by the transmission unit.
  • the frequency of the electromagnetic radiation emitted by the tag may be distinct from the radiation emitted from the transmission unit. In this manner, it may be possible to identify and distinguish the two signals.
  • the frequency of the signal from the tag may lie within a side range of the frequency of
  • antenna 118 may comprise a Bluetooth antenna. In such embodiments,
  • multiple corresponding Bluetooth receivers at known locations may be configured to sense signal strengths from the Bluetooth antenna 118 and triangulate such data in order to localize the signal from the Bluetooth antenna 118 and thereby locate the TD within a patient's body.
  • Other embodiments may be configured to use angle-based, electronic localization techniques and equipment in order to locate the antenna 118. Some such embodiments may comprise use of directional antennas, which may be useful to increase the
  • Still other embodiments may comprise use of other types of hardware and/or signals that may be useful for localization, such as WIFl and cellular signals, for example.
  • One or more receiver units may be set up to receive the signal from the tag. By evaluating, for example, the strength of the signal at various receiver units, the distances from the various receiver units may be determined. By so determining such distances, a precise location of the TD relative to a patient
  • a display screen with appropriate software may be coupled with the RFID or other localization technology to allow a surgeon to visualize at least an approximate location of the tag, and therefore TD, relative to the patient's body.
  • Some embodiments may be further configured such that data from the antenna(s) may be used in 580 connection with sensor data from the TD.
  • some embodiments of TDs comprising one or more sensors may be further configured with one or more RFID tags or other antenna(s).
  • data from the one or more sensors may be paired or otherwise used in connection with data from the one or more antenna(s).
  • some embodiments may be configured to provide information to a surgeon regarding one or more locations on the body from which one or more sensor readings were obtained.
  • information regarding tissue concentration of a particular protein and/or nucleic acid may be combined with a location from which such tissue concentration(s) were taken. In this manner, a surgeon may be provided with specific information regarding which locations within a patient's body have been adequately sampled or otherwise found to contain the concentrations referenced aboveTD.
  • a visual display may be provided comprising an image of the patient's body and/or one or more selected regions of a patient's body.
  • Such a system may be configured so as to provide a visual indication for one or more regions within the image corresponding to regions of the patient's tissue that have been sufficiently analyzed.
  • a display of a patient's liver may change colors at locations on the display that correspond with regions of the liver that have been detected to
  • regions 595 contain a specified range of hepatitis virus.
  • Such regions may, in some embodiments, be configured such that pixels corresponding to particular regions only light up after the corresponding tissue in that region reaches a particular threshold concentration.
  • tip 101 may be attached to a robotic arm. In some embodiments, tip 101 and portion of shaft 102 may be attached to a robotic arm. In some embodiments tip 101 and/or a portion of
  • the robotic arm may comprise one or more motors such as a screw-drive motor, gear motor, hydraulic motors, etc.
  • the robotic arm system may comprise worm gearheads, video cameras, motor control circuits, monitors, remote control devices, illumination sources, tactile interface, etc.
  • Figures 1 k and 1 L depict alternative embodiments of a TD in which cover 180 comprises one or more
  • cover 180 may be configured to at least substantially seal (other than opening(s) 180k) an interior space such that a vacuum applied via port 187 may result in suction through opening 180k.
  • the opening(s) 180k may have a round shape.
  • openings 180k may measure about 1.5mm in diameter.
  • openings 180k may range in diameter from about 100 microns to about 100mm.
  • openings 180k may have a variety of geometric shapes including but not limited to square, rectangular, and/or polygonal.
  • sensor 189k may comprise a nanosensor.
  • cover 180
  • seat 188 may elevate or decline to allow sensor 189k to approach and/or move away from opening 180k in order to increase and/or decrease contact with tissues and/or fluids that may be suctioned into the space inside of cover 180 and dock 184 when suction is applied via suction port 187.
  • Actuators not seen in this view but discussed
  • 620 elsewhere in this disclosure may be configured to move seat 188 and/or sensor 189k.
  • suction When suction is applied via suction port 187, fluids and/or tissues external to cover 180 may be forced/pulled into contact with the edges of openings 180k and these may be further pulled through openings 180k with or without gross movement of the TD. Fluids and/or tissues that were previously external to the TD may be brought into contact with sensor 189k for analysis.
  • Fluid entry into cover 180 may be facilitated or prevented by several factors including but not limited to size of openings, outside environment, tissue environment, and/or positive pressure of fluids/gasses from fluid delivery port 186 and/or vacuum from fluid extraction port 187.
  • the shaft of FIG. 1 k further comprises antenna 118k.
  • 118k represents an antenna configured to deliver a signal to a receiver unit.
  • antenna 118k may comprise any of the antennas described elsewhere herein including for example any of the antennas discussed in connection with antenna 118k.
  • the RFID tag may comprise an RFID transponder.
  • openings 180L are/are present in cover 180.
  • the opening(s) 180L may have a round shape.
  • openings 180L may measure about 1.5mm in diameter.
  • at least a portion of sensor 189L is allowed to protrude through a portion of the TD into the space external to the TD for body tissue and/or fluid sensing and/or sampling and/or testing.
  • openings 180L may range in
  • openings 180L may have a variety of geometric shapes including but not limited to square, rectangular, and/or polygonal.
  • a rectangular shaped opening may allow for sensors deployed on a strip to pass through the opening.
  • Sensors 189L deployed on a strip may pass through opening(s) 180L, as shown in Figure 1 L.
  • a strip seen from the side view may look like a line.
  • the sensors and/or the material are not limited to square, rectangular, and/or polygonal.
  • sensor 189L is a nanosensor.
  • cover 180 may be configured to at least substantially seal an interior space such that a vacuum applied via port 187 may result in suction through opening(s) 180L.
  • a vacuum applied via port 187 may result in suction through opening(s) 180L.
  • Fig. 1 L at least a portion of a sensor may protrude
  • seat 188 may elevate or decline to allow sensor 189L to pass through opening 180L in order to contact tissues and/or fluids outside the cover and/or dock and/or TD and/or return back into the area under the cover adjacent to the dock.
  • Actuators not seen in this view but discussed elsewhere in this disclosure may be configured move seat 188 and/or sensor 189L. Fluid entry into cover 180 may be
  • Sensor 189L may receive and/or send one or more signals from and/or back to a processing unit to be analyzed while deployed outside of the cover and/or once retracted back under the cover. After sensor 189L is retracted back through the cover, it may be cleaned as discussed
  • Sensor 189L may be coupled with an antenna, which may send and/or receive one or more signals to/from a processing unit while sensor 189L is deployed outside of cover 180.
  • data from sensor 189L resulting from tissue and/or fluid analysis using sensor 189L may be stored locally and transmitted later. For example, a signal including such analysis data may be transmitted after sensor
  • such a signal may be transmitted following surgery.
  • the signals need not necessarily be transmitted wirelessly.
  • some embodiments may be configured to store data locally, after which a data module, such as a memory stick, may be removed from the TDAOM and uploaded to a separate computer for analysis.
  • sensor 189L After sensor 189L is retracted back into cover 180, it may be cleaned, as discussed elsewhere in this disclosure.
  • at least a portion of sensor 189L may be positioned on a flexible roll and/or may be disposable.
  • some embodiments may comprise one or more flexible nanosensors 189L positioned on a flexible roll or stack such that portions of the roll/stack may protrude from a portion of cover 180, such as through opening(s) 180L, for analysis.
  • some embodiments may be configured to wind the roll, flip the stack, and/or discard of the used portion of sensor 189L and/or to expose a new portion of sensor 189L for further analysis.
  • used portion(s) of sensor 189L may be stored with the TD/TDM and discarded elsewhere following the procedure.
  • at least a portion of a flexible nanosensor 189L, such as a nanosensor on a flexible roll, may protrude from a portion of a TD/TDM without being manually
  • Flexible nanosensors may be obtained/manufactured by methods available to those of ordinary skill in the art, including but not limited to: Fabrication of Nanowire Electronics on Nonconventional Substrates By Water-Assisted Transfer Printing Method (Lee, Kim, Zheng; Nano Lett, 2011 , 11 (8):3435-9) and Vertical Transfer of Uniform Silicon Nanowire Arrays Via Crack Formation (Weisse, Kim, Lee, Zheng; Nano Lett 2011 , 11(3): 1300-1305), which is hereby incorporated by
  • the shaft of FIG. 1 L further comprises antenna 118L.
  • 118L represents an antenna configured to deliver a signal to a receiver unit.
  • antenna 118L may comprise any of the antennas described elsewhere herein including for example any of the antennas discussed in connection with antenna 118L.
  • antenna 118L comprises an RFID
  • the RFID tag may comprise an RFID transponder.
  • tip 101 may be made of materials that are both electrically non-conductive and of low thermal conductivity such as porcelain, epoxies, ceramics, glass-ceramics, plastics, or varieties of polytetrafluoroethylene.
  • the tip may be made from
  • the relative recessions of the tip is the electrically conductive tissue lysing element 105 (usually hidden from view at most angles) which may have any geometric shape including a thin cylindrical wire; the electrically conductive lysing element can be in the shape of a plate or plane or wire and made of any metal or alloy
  • Optimal materials may include but are not limited to steel, nickel, alloys, palladium, gold, tungsten, silver, copper, and platinum. Metals may become oxidized thus impeding electrical flow and function.
  • the geometry of the tip area may comprise protrusions that are not oriented along the axis of the shaft (as seen from a top view); some of these alternative embodiments for tip area geometries are depicted in Figures 5a,b,c,d.
  • Some embodiments may be configured to be modular and/or comprise disposable tips such that a surgeon can place an appropriate tip for a particular surgery on the shaft.
  • one or more of the tips may be disposable such that a surgeon may dispose of the tip after performing surgery and install a new tip for subsequent surgeries or a continuation of the current surgery with a new tip.
  • An energy window 107 may be present on the upper side of the device. In some embodiments energy
  • 710 winow 107 comprises an electrosurgically energized window. It is contemplated that in alternative embodiments, energy window 107 may be omitted. It should be noted that the term “energy window” is intended to encompass what is referred to as a planar-tissue-altering-window/zone in U.S. Patent No. 7,494,488 and, as described later, need not be electrosurgically energized in all embodiments. In some embodiments, the "energy window” may comprise a variety of other energy emitting devices, including 715 radiofrequency, intense pulsed light, LASER, thermal, microwave and ultrasonic. It should also be understood that the term “energy window” does not necessarily imply that energy is delivered uniformly throughout the region comprising the energy window. Instead, some energy window implementations may comprise a series of termini or other regions within which energy is delivered with interspersed regions within which no energy, or less energy, is delivered. This configuration may be useful for some
  • a second energy window may also be included in some embodiments, and may comprise a radiofrequency electrosurgery or another variety of energy emitting device.
  • Electro-coagulation and/or electro-cutting energy may arrive in conduits 111 and/or 112.
  • electrocoagulation energy may travel by wiring through the handle and shaft to termini 107a, which are part of energy window 107. Electro-cutting and electro-coagulation currents may be controlled outside the TD at an electrosurgical generator, such as the Bovie Aaron 1250TM or Bovie Icon GPTM.
  • energy window 107 comprises an electrosurgical energy window. In the depicted embodiment, energy window 107 comprises one or more electrosurgical elements. In the depicted
  • energy window 107 comprises one or more hollow protruding ceramic termini 107a atop a nonconductive ceramic plate; one or more conductive metal pins pass may through the hollow termini and may be electrically connected to electrical leads which may pass through said conduits.
  • the metal pins, of termini 107a comprise surgical stainless steel pins.
  • the metal pins comprise an electroconductive coating such as for example, Silverglide®
  • nonconductive hollow ceramic termini 107a protrude about 2mm above the plane of energy window 107, which is flush with the plane of tip 101 and shaft 102.
  • energy window 107 may
  • energy window 107 may measure about 10mm x 15mm. In some embodiments, energy window 107 may lie below the plane of tip 101 and/or shaft 102. In contemplated embodiments, nonconductive hollow ceramic termini 107a may protrude a range of about 0.5mm-20mm above the plane of the energy window. In the depicted embodiment, one or more holes in termini 107a measure about 1.5mm in diameter and/or conductive pins measure 1.2mm in
  • electrocoagulation current reaches metallic pins in termini 107a of window 107 from a standard hospital electrosurgical generator.
  • standard electrosurgical generators which may be used to power an electrosurgical energy window, may include those manufactured by Bovie Medical, i.e. Model Aaron1250 and IconGP (Clearwater, Florida, USA) and/or Valleylab/Covidian Model Surgistat 2 (Boulder, Colorado) and/or Erbe Electrosurgical (Tubingen, Germany) etc.
  • Bovie Medical i.e. Model Aaron1250 and IconGP (Clearwater, Florida, USA) and/or Valleylab/Covidian Model Surgistat 2 (Boulder, Colorado) and/or Erbe Electrosurgical (Tubingen, Germany) etc.
  • electrosurgical generators may have a maximal output power that may range from about 80W to 120W.
  • said electrosurgical generators are operated on a 'Coag/Coagulation' power setting of 20-80% of maximal output while the TDM is motionless and/or moved by the surgeon.
  • the TDM is moved at about 1cm per second by the surgeon.
  • the 755 window is pulsed at a rate ranging from about 20cycle per second to 50cycles per second.
  • the electrocoagulation energy reaching electrosurgical energy window is pulsed at rates ranging from about 1 cycle per second to 200cycles per second.
  • the electrosurgically energized window current can be further pulsed at varying rates, by interpolating gating circuitry at some point external to the electrosurgical generator by standard mechanisms known in the art.
  • the electrosurgically energized window current can be further pulsed at varying rates by gating circuitry within the electrosurgical generator by standard mechanisms known in the art.
  • the electrosurgical energy window 107 may be located on shaft 102.
  • the electrosurgical energy window 107 comprises an electroconductive plate with termini, encased by an electrical insulator coat except at one or more points on
  • termini are pressed into the electroconductive plate.
  • the electroconductive plate comprises a metal plate and/or a cermet.
  • the metal plate comprises surgical stainless steel.
  • the electroconductive plate and/or termini may be directly coated with an electroconductive coating such as for example, Silverglide® coating (from Stryker, Silverglide® Surgical, Kalamazoo, Michigan, USA) and/or gold and/or titanium nitride (Strem
  • the electroconductive plate may be coated with an electrically insulating coat.
  • an electroconductive coat is placed upon the electroconductive plate before an insulating coat.
  • the electrical insulator comprises a nonconductive anti-stick polymer such as polytetrafluroethylene.
  • a nonconductive coating may cover an electroconductive place ranging from about 90% coverage to 98% coverage.
  • the insulated electroconductive plate may be substantially planar and may comprise one or more defects in the insulating surface coating which may allow one or more exit points for electrons (electrosurgical energy).
  • the geometry of one or more of such defects is circular and/or square and/or triangular and/or geometric in shape.
  • the 780 layer covering may range from about 1 mm to about 20mm
  • the defects may form a pattern.
  • the tip may measure about 1cm in width and about 1-2 mm in thickness. Sizes of about one-fifth to about five times these dimensions may also have possible uses. In some veterinary embodiments, tip sizes of about one-tenth to 20 times the aforementioned dimensions may also have
  • the tip can be a separate piece that is secured to shaft by a variety of methods such as a snap mechanism, mating grooves, plastic sonic welding, etc.
  • the tip can be integral or a continuation of shaft made of similar metal or materials.
  • the tip may also be constructed of materials that are both electrically non-conductive and of low thermal conductivity; such materials might comprise, for example, porcelain, ceramics, glass-
  • the tip may be constructed of a support matrix of an insulating material (e.g., ceramic or glass material such as alumina, zirconia). Lysing segment energy conduit 111 connects to electrically conductive elements to bring RF electrosurgical energy from an electrosurgical generator down 795 the shaft 102 to electrically conductive lysing elements 105 mounted in the recessions in between the protrusions 104.
  • the protrusions may comprise bulbous protrusions.
  • the tip shown in this embodiment has four relative protrusions and three relative recessions and provides for a monopolar tip conductive element.
  • All of the axes of the relative protrusions of the tip depicted in this embodiment extend at least substantially parallel to the axis of the shaft of the TD (as viewed from Top).
  • surgeons may use methods of defining and or dissecting a target area by entering through an incision and then moving the TD tip in a primarily axial direction forward and backward and reorienting the TD after the backstroke in a spokewheel pattern the TD to access tissues adjacent to earlier strokes.
  • some of the protrusions and lysing segments may be oriented in a non-axial direction.
  • the tip 101 may alternatively be made partially or completely of concentrically laminated or annealed-in wafer layers of materials that may include plastics, silicon, glass, glass/ceramics, cermets or ceramics. Lysing elements 105 may also be made partially or completely of a cermet material. Alternatively, in a further embodiment the tip may be constructed of insulation covered metals or electroconductive materials.
  • the shaft may be flat, rectangular or 810 geometric in cross-section or substantially flattened. In some embodiments, smoothing of the edges of the shaft may reduce friction on the skin surrounding the entrance wound.
  • the shaft may be made of metal or plastic or other material with a completely occupied or hollow interior that can contain insulated wires, electrical conductors, fluid/gas pumping or suctioning conduits, fiber-optics, or insulation.
  • the shaft may have a length of about 10-20cm. In some embodiments the handle may have a length of about 8-18cm.
  • shaft plastics such as polytetrafluoroethylene may act as insulation about wire or electrically conductive elements.
  • the shaft may alternatively be made partially or completely of concentrically laminated or annealed-in wafer layers of materials that may include plastics,
  • the energy window 107 may only be substantially planar, or may take on other cross-sectional shapes that may correspond with a portion of the shape of the shaft, such as arced, stair-step, or other geometric shapes/curvatures. In the embodiments depicted in FIGS. 1a & 1 b, energy window 107 is adjacent to protrusions 104, however other embodiments are contemplated in which an energy window may be
  • Conduits may also contain electrical control wires to aid in device operation. Partially hidden from direct view in FIGS. 1a & 1 b, and located in the grooves defined by protrusions 104 are electrically
  • conductive tissue lysing elements 105 which, when powered by an electrosurgical generator, effects lysing of tissue planes on forward motion of the device.
  • the lysing segments may be located at the termini of conductive elements.
  • one or more sensors such as for example sensors 110 and 114 may be positioned on the device.
  • the sensors 110 and 114 may comprise any of the sensors described in the specification herein.
  • Other embodiments may comprise one or more sensors on any other
  • TD suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • Sensors that may be useful include thermal sensors, photoelectric or photo optic sensors, cameras, etc.
  • one or more sensors may be used to monitor the local post passage electrical impedance or thermal conditions that may exist near the distal tip of the shaft or on the tip.
  • Some embodiments may also comprise one or more sensors incorporating MEMS (Micro Electro-Mechanical
  • sensor 840 Systems such as MEMS gyroscopes, accelerometers, and the like.
  • sensors may be positioned at any number of locations on the TD, including within the handle in some embodiments.
  • sensor 114 may comprise fiberoptic elements.
  • the sensor can be configured to sense a temperature of tissue adjacent to the apparatus.
  • the temperature sensor may alternatively be configured or sense a temperature of one or more fluids adjacent to the apparatus such as
  • tissue fluids and/or fluids introduced by the surgeon for example tissue fluids and/or fluids introduced by the surgeon.
  • Temperature and impedance values may be tracked on a display screen or directly linked to a microprocessor capable of signaling control electronics to alter the energy delivered to the tip when preset values are approached or exceeded.
  • Typical instrumentation paths are widely known, such as thermal sensing thermistors, and may feed to analog amplifiers which, in turn, feed analog digital converters
  • internal or external ultrasound measurements may also provide information which may be incorporated into a feedback circuit.
  • an optional mid and low frequency ultrasound transducer may also be activated to transmit energy to the tip and provide additional heating and may additionally improve lysing.
  • a flashing visible light source for example, an LED, can be mounted on the tip may show through the tissues and/or organs
  • one or more electromagnetic delivery elements 115 may be positioned on tip or shaft.
  • Other embodiments may comprise one or more electromagnetic delivery elements on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • Electromagnetic delivery elements that may be useful include: LEDs, LASERS, fiberoptics,
  • a second energy window 108 may also be included in some embodiments, and may comprise yet another ultrasonic energy emitter or another variety of energy emitting device.
  • An ultrasonically energized energy window 108 may be present on the upper side of the device. It is contemplated that in alternative embodiments, energy window 108 may be omitted. It should be noted that the term "energy window" is
  • the "energy window” may comprise a variety of other energy emitting devices, including ultrasonic, intense pulsed light, LASER, thermal, microwave and electrical. It should also be understood that the term “energy window” does not necessarily imply that energy is delivered uniformly throughout the
  • some energy window implementations may comprise a series of energy delivering elements or other regions within which energy is delivered with interspersed regions within which no energy, or less energy, is delivered.
  • An ultrasonic energy window configuration may be useful for some implementations, depending upon piezoelectric component and/or energy applied to less aggressively disrupt tissues (in order to possibly increase the concentration of target chemicals
  • Energy window 108 may only be at least substantially planar, or may take on other cross-sectional shapes that may correspond with a portion of the shape of the shaft, such as arced, stair-step, or other geometric shapes/curvatures.
  • Some embodiments may comprise a low cost, disposable, and one-time-use device.
  • the tip's electrically conductive tissue lysing elements be protected or coated with materials that include, but are not limited to, SilverglideTM non-stick surgical coating, platinum, palladium, gold and rhodium. Varying the amount of protective coating allows for embodiments of varying potential for obsolescence capable of either prolonging or shortening instrument 885 life.
  • the electrically conductive lysing element portion of the tip may arise from a plane or plate of varying shapes derived from the aforementioned materials by methods known in the manufacturing art, including but not limited to additive manufacturing, cutting, stamping, pouring, molding, filing and sanding.
  • the electrically conductive lysing element 105 may comprise an 890 insert attached to a conductive element in the shaft or continuous with a formed conductive element coursing all or part of the shaft.
  • a lysing segment energy conduit 111 brings RF electrosurgical energy down the shaft to electrically conductive lysing elements 105 associated in part with the recessions.
  • the electrosurgical energy via conduit 111 is predominately electro- cutting.
  • the electrically conductive element or wiring may be bifurcated to employ hand switching if an optional finger switch is located on handle.
  • the electrically conductive element or wiring leading from the shaft into the handle may be bundled with other leads or energy delivering cables, wiring and the like and may exit the proximal handle as insulated general wiring to various generators (including electrosurgical), central processing units, lasers and other sources as have been described herein.
  • generators including electrosurgical
  • central processing units including lasers and other sources as have been described herein.
  • the plate making up lysing segments 105 may be sharpened or scalloped or made to slightly extend outwardly from the tip recessions into which the plate will fit.
  • the lysing element may be recessed into the relative recessions or grooves defined by the protrusions 104 or, alternatively, may be flush with protrusions 104.
  • locations of the electrically conductive lysing elements with respect to the protrusions may be adjusted by diminutive screws or ratchets. In some further adjustable embodiments, locations of the electrically conductive lysing elements with respect to the protrusions may be adjusted by MEMS or microelectronics.
  • the plate which in some embodiments is between 0.01 mm and 1 mm thick, can be sharpened to varying degrees on its forward facing surface. It is possible that plate sharpness may
  • the plate thickness may vary from 0.001 mm to 3mm thick.
  • the electrically conductive lysing element may also exist in the shape of a
  • an electrosurgical current for the electrically conductive lysing element is of the monopolar "cutting" variety and setting and may be delivered to the tip lysing conductor in a continuous fashion or,
  • the electrosurgically energized window current can be further pulsed at varying rates, by interpolating gating circuitry at some point external to the electrosurgical generator by standard 925 mechanisms known in the art.
  • the electrosurgically energized window current can be further pulsed at varying rates by gating circuitry within the electrosurgical generator by standard mechanisms known in the art.
  • the electrically conductive lysing element is a monopolar tip in contact with conductive elements in the shaft leading to external surgical cable leading to an electrosurgical generator from which emanates a grounding or dispersive plate which may be placed
  • the tip may also be manufactured from multilayer wafer substrates comprised of bonded conductive strips and ceramics. Suitable conductive materials include but are not limited to those already described for tip manufacture.
  • the electrically conductive lysing elements may be bifurcated or divided into even numbers at the relative recessions, insulated and energized by wiring to an even number of leads in a bipolar fashion and connected to the bipolar outlets of the aforementioned electrosurgical generators. Rings partly or completely encircling the shaft of the hand unit can be linked to a partner bipolar electrode at the tip or on the energy window. Such bipolar versions may decrease the available power necessary to
  • the lysing elements may be divided into odd numbers yet still allow for bipolar flow between two or more elements as those of ordinary skill in the art would appreciate.
  • FIGS 2a-j depict various views of a particular embodiment of a tissue dissector (TD) with a sensor dock on the upper side of the device with a movable cover.
  • TD tissue dissector
  • FIG. 2a is a perspective view of an embodiment of a TD comprising a tip 201 , a shaft 202 and a handle
  • sensor 289 may comprise an optical sensor. In some embodiments sensor 289 may comprise an optical biosensor. In some embodiments sensor 289 may comprise a fiberoptic.
  • sensor 289 comprises a fiberoptic element(s) positioned in an optics-seat.
  • sensor 289 may be positioned in seat 288 without an optics-seat.
  • sensor 289 comprise a fiberoptic biosensor.
  • the fiberoptics may protrude from a fiberoptic-seat.
  • fiberoptics may be flush with or recessed from an adjacent and/or surface in which they are bound.
  • Optical sensors may be obtained/manufactured by methods available to those of ordinary skill in the art, including but not limited to:
  • some of the reagents and/or chemicals and/or biochemicals that may be present in and/or delivered to and/or removed from the dock area to facilitate sensor use and/or cleaning, etc. may include but not be limited to ethanolic solutions, thiols, SDS (sodium dodecyl sulfate), water, argon gas, sodium chloride, sodium bicarbonate buffer, EGTA (ethylene glycol tetraacetic acid), EDTA
  • FIG. 2a a perspective view of an embodiment of a TD comprising a tip 201 , a shaft 202 and a handle 203.
  • dock 284 Located on the shaft is dock 284 that may accommodate seat 288 which may
  • sensor 289 may comprise a optical sensor.
  • dock 284 may be recessed into shaft 202 and/or tip 201.
  • dock 284 may protrude from shaft 202 and/or tip 201.
  • dock 284 may be flush with shaft 202 and/or tip 201.
  • sensor 289 may comprise a fiberoptic sensor.
  • the sensor 189 may comprise a biological optical sensor.
  • seat 288 1000 may be fixed in position.
  • seat 288 may be moveable.
  • sensor 284 may be fixed in seat 288.
  • the sensor 289 may be detachable seat 288.
  • seat 288 may be omitted.
  • the dock may comprise cover moving means and/or a cover tip.
  • Cover tip 281 and means for selectively moving a cover 283 may be positioned adjacent dock 284.
  • Examples of such cover moving means may 1005 include rails, grooves, tracks, ratchets, cables, arms, lines, etc.
  • the cover moving means comprises a rail.
  • a portion of the shaft may comprise cover moving means 283.
  • cover moving means 283 may be omitted.
  • Dock 284 may comprise one or more dock wall(s) 285.
  • Dock wall 285 may comprise fluid delivery port 286 for fluid delivery conduit.
  • Dock wall 285 may comprise fluid extraction port 287 for fluid extraction
  • dock wall 285 may comprise one or more ports 286 and/or 287.
  • cover 280 is moveable along cover moving means 283 and may be opened or closed via internal control wires. In some embodiments the cover may be moved by motors.
  • Rear end of cover 282 may be fixed to cover 280. In some embodiments, rear end of cover 282 is not fixed to cover and is itself attached to another portion of the TD.
  • dock 284 and/or dock wall 285 may accommodate a
  • Temperature modification means 295 may comprise, for example a heater, a Peltier cooler, a heat pump, etc. Temperature modification means 295 may be used to heat fluids introduced by way of port 286. Temperature modification means 295 may alternatively be used to heat tissues and/or other fluids such as body tissues and/or fluids captured during a procedure using the TD. In some embodiments temperature
  • modification means 295 may facilitate and/or inhibit certain chemical reactions and/or bond alterations that may be needed in order to sense certain biomaterials using sensor 289.
  • dock 284 and/or dock wall 285 may accommodate mixing element 296.
  • temperature modification means 295 may comprise an electrical resistance heater.
  • heater 295 may comprise a thin film resistor and/or piezoelectric heating device and/or other device
  • mixing element 296 may comprise a propeller driven by an electric motor.
  • mixing element 296 may comprise one or more flaps of relatively inert flexible polymeric plastic on a post spun by an electric motor. Examples of other materials for such a flap may include polymers, metals, ceramics, etc.
  • mixing element 296 may comprise an unattached stirring rod spun by oscillating magnet.
  • a contemplated embodiment a
  • separate set of ports may originate and terminate in dock 284, and may be connected by conduit which is fluidly coupled with a piezoelectric pump and/or another fluidic motor and/or another fluidic driving device.
  • such port(s) may be positioned at an opposite end of dock 284 such that delivery of fluid(s) and/or application of a vacuum may be applied more evenly throughout dock 284. It is contemplated that in alternative embodiments, temperature modification means
  • One or more sensors 278 and/or 279 may be located on dock 284. In some embodiments, one or more sensors 278 and/or 279 may be located on dock wall 285 and/or cover 280. Sensors 278 and/or 279 may comprise any of the specific examples of sensors discussed in connection with sensors 210 and/or 214. Sensor(s) 278 and/or 279 may report conditions and/or changing conditions in dock area 184 in and/or around optical sensor 289.
  • sensor 278 and or sensor 279 may comprise a camera. In some embodiments, sensor 278 and or sensor 279 may comprise a fiberoptic and/or fiberoptic camera and/or CCD camera and/or other camera.
  • one or more electromagnetic delivery elements 277 may be positioned on dock 284 tip and/or cover 280 and/or tip of cover 281.
  • Other embodiments may comprise one or more
  • Electromagnetic delivery elements on any other suitable location on the TD, including but not limited to on the sensor 289 or otherwise on seat 288.
  • Electromagnetic delivery elements that may be useful include but are not limited to: LEDs, LASERS, fiberoptics, filaments, photoelectric materials, infrared emitters, etc.
  • emission of such electromagnetic energy may be absorbed by a chemical and/or biomolecule on the sensor and/or dock area and/or reflectance and/or emission spectra of the chemical
  • cover 280 and/or dock 284 may be configured to reflect electromagnetic radiation. Reflecting electromagnetic radiation and/or having mirror-like properties may allow for detection of electromagnetic radiation by sensors 278 and/or 279.
  • cover 280 and/or dock 284 comprise a thin film coating over a substrate.
  • the substrate may be plastics and/or
  • cover 280 and/or dock 284 comprise a coating of aluminum.
  • the aluminum coating comprises a protected aluminum and/or enhanced aluminum and/or UV-enhanced aluminum (a maker may be Edmund Optics, Barrington, NJ, USA).
  • cover 280 may comprise plastic. In other embodiments cover 280 may comprise plastic. In other embodiments cover 280 may
  • 1060 comprise materials including but not limited to: polymers, quartz, glass, carbon based materials, silicates and/or metals.
  • the conduit may also contain electrical control wires to aid in device operation.
  • electrically conductive tissue lysing elements 205 Partially hidden from direct view in FIGS. 2a & 2b, and located in the grooves defined by protrusions 204 are electrically conductive tissue lysing elements 205, which, when powered by an electrosurgical generator, effects lysing
  • sensors 210 and 214 may be positioned on the device.
  • the sensors 210 and 214 may comprise any of the sensors described in the specification herein.
  • sensor 210 and or sensor 214 may comprise a camera.
  • sensor 210 and or sensor 214 may comprise a fiberoptic and/or fiberoptic
  • TD 1070 camera and/or CCD camera and/or other camera may comprise one or more sensors on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft. Sensors that may be useful include thermal sensors, photoelectric or photo optic sensors, cameras, etc. In some embodiments, one or more sensors may be used to monitor the local post passage electrical impedance or thermal conditions that may exist near the distal tip of the shaft or on the
  • Some embodiments may also comprise one or more sensors incorporating MEMS (Micro Electro- Mechanical Systems) technology, such as MEMS gyroscopes, accelerometers, and the like. Such sensors may be positioned at any number of locations on the TD, including within the handle in some embodiments.
  • sensor 214 may comprise fiberoptic elements.
  • the sensor can be configured to sense a temperature of tissue adjacent to the apparatus. The temperature sensor may
  • 1080 alternatively be configured or sense a temperature of one or more fluids adjacent to the apparatus such as for example tissue fluids and/or fluids introduced by the surgeon.
  • Temperature and impedance values may be tracked on a display screen or directly linked to a microprocessor capable of signaling control electronics to alter the energy delivered to the tip when preset values are approached or exceeded.
  • Typical instrumentation paths are widely known, such as thermal
  • thermistors 1085 sensing thermistors, and may feed to analog amplifiers which, in turn, feed analog digital converters leading to a microprocessor.
  • internal or external ultrasound measurements may also provide information which may be incorporated into a feedback circuit.
  • an optional mid and low frequency ultrasound transducer may also be activated to transmit energy to the tip and provide additional heating and may additionally improve lysing.
  • a flashing visible light may also be activated to transmit energy to the tip and provide additional heating and may additionally improve lysing.
  • 1090 light source for example, an LED
  • the tip may show through the tissues and/or organs to identify the location of the device.
  • one or more electromagnetic delivery elements 215 may be positioned on tip or shaft.
  • Other embodiments may comprise one or more electromagnetic delivery elements on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on
  • Electromagnetic delivery elements that may be useful include: LEDs, LASERS, fiberoptics, filaments, photoelectric materials, infrared emitters, etc.
  • handle 203 may comprise one or more ports through which various conduits may be passed.
  • a plurality of conduits may be bundled together for convenience if desired.
  • an energy delivery conduit bundle 298 may be bundled together for convenience if desired.
  • 1100 may be provided, which may comprise a lysing segment energy conduit 211 and an energy window conduit
  • miscellaneous conduit bundle 299 may be provided.
  • Miscellaneous conduit bundle 299 may comprise, for example, various other conduits, such as conduits for one or more sensors, such as sensors 210 and 214, one or more electromagnetic delivery elements 215, fluid delivery port(s) 216, and/or suction/vacuum ports 217.
  • miscellaneous conduit bundle 299 may comprise one or more
  • Miscellaneous conduit bundle 299 may further comprise one or more fluid extraction conduits (from port 287 in dock 284) for extracting of fluid to direct the fluid (again, a liquid or gas) to a remote fluid/chemical sensor.
  • the fluid delivery conduit (leading to port 286) may be configured to deliver, for example, buffers,
  • Fluids delivered may be energized, such as heated, ultrasonically energized, may contain detergents, antibodies, drugs, etc.
  • Fluid extraction conduits may not only be used to withdraw fluids to be discarded from the body, but also may be used in a wash circuit to remove fluids introduced by way of fluid
  • 1115 delivery conduit leading to port 286 that are used to, for example, wash and/or disinfect certain tissues and/or components of the TD.
  • Fluid extraction conduit (leading from port 287) may also be used to extract fluids for external analysis. Some embodiments may be configured to provide a bubble between separate sets of fluids to allow a user to distinguish between various fluid streams delivered using fluid extraction conduit leading from port 287.
  • a vibration means 270 may be positioned in the handle.
  • Other embodiments may comprise one or more vibration means on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • suitable vibration means may include piezoelectric materials, ultrasonic motors with stators, piezoelectric actuators, vibration motor such as an off-center weight mounted on a gear, etc.
  • Some vibration means may be configured to emit
  • vibration means may include electromagnet drivers with a frequency of operation in the range of 150-400Hz.
  • one or more vibration means may be used to provide additional forces which may facilitate passage of the TD.
  • one or more vibration means may be used to reduce debris on the electrosurgical or other components of the TD.
  • a vibration means may be directly or indirectly connected to one or
  • vibration means may help to decrease and/or remove debris.
  • use of a vibration means may, also or alternatively, be used to assist in migrating the TD through tissue during the procedure.
  • it is thought that use of a vibration means having a lower frequency may be particularly useful for assisting in such migration.
  • positioning the vibration means closer to a handle of the TD may facilitate such migration as well.
  • positioning the vibration means on or near the tip, and/or using a higher frequency vibrations means may be particularly useful for preventing buildup of debris on the tip.
  • Figures 2 d, c depict the TD with cover 280 moved proximally to expose dock.
  • Figures 2 f, e depict the TD with cover 280 moved distally to close over and/or seal dock.
  • FIG. 2g is cross sectional view of an embodiment of cover 280 comprising a groove 291 and projection
  • Groove 292 may be used to direct fluids within cover 280 to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations and/or bringing fluids of with a temperature range to locations within the dock or cover.
  • projection 292 may also be used to direct fluids to one or more desired locations and/or agitate fluids in a desired manner for a particular use.
  • FIG. 2h is cross sectional view of an embodiment of dock 284 comprising a groove 293 and a projection 294 as described herein.
  • Groove 293 may be used to direct fluids within dock 284 to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations and/or bringing fluids of with a temperature range to locations within the dock or cover.
  • projection 294 may also be used to direct fluids to one or more desired locations
  • cover grooves 291 may operate in conjunction with dock grooves 293 or dock protrusions 294 to impact fluid behavior in a desired manner.
  • one or more grooves 291 and 293 may be provided for example in dock 284
  • grooves may be configured to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations.
  • projections 292 and 294 may be provided for example in dock 284 and/or in an interior surface of cover 280 in order to direct fluids delivered through port 286 are directed to desired to
  • projections may be configured to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations.
  • multiple projections may define a groove, in other embodiments one or more grooves may be formed within a surface of a cover and/or dock.
  • cover 280 which may facilitate cleaning.
  • Closing cover 280 may also facilitate isolation of biological tissues and/or fluids.
  • closure of cover 280 may allow for analysis of tosses and/or fluids while preventing contamination by other such tissues and fluids after a sample has been taken. Cleaning may be further facilitated by positioning of the seat and/or sensors at an angle and/or various angles.
  • the configuration depicted in Figure 1 i may be primarily for facilitating capture to tissue and/or fluids for
  • some embodiments may be configured to tilt seat 288 toward a rear portion of the TD such that it faces (tilts toward) fluid port 286 to facilitate cleaning of sensor 289.
  • Fluid delivery port 286 for fluid delivery and fluid extraction port 287 for fluid extraction may also serve to deliver and/or remove fluids, for example, including but not limited to reagents and/or analyte(s) and/or eluent(s) and/or eluate(s). In some embodiments, fluid delivery from fluid delivery port 286 and/or fluid
  • 1175 extraction from fluid extraction port 287 may be linked in a circuit with a pump and/or additional conduit (that is coupled with one or both of the conduits coupled with fluid delivery port 286 and fluid extraction port 287) to recirculate and/or heat and/or incubate and/or mix and/or add reagents and/or remove reagents and/or other materials from the space within the cover 280 and/or dock 284.
  • a pump external to the TD, fluidly connected to the circuit between the conduits connecting ports 287 and
  • the available space for fluids between the cover 280 and dock 284 may be derived by measuring an amount of fluid entering and/or exiting from ports 286 and/or 287 via their conduits. Such measurements may be compared with CAD (Computer Aided Design) calculations of the space.
  • CAD Computer Aided Design
  • Fig. 2i is a side (break away) side view, of of the embodiment previously depicted in FIG. 2a of a TD,
  • the TD may comprise an actuator 290.
  • actuator 290 may comprise a motor.
  • actuator 290 may comprise one or more such motors such as a screw-drive motor, gear motor, hydraulic motors etc.
  • actuator 290 may comprise worm gearheads, motor control circuits, monitors, remote control
  • actuator 290 may be controlled or moved by wire and/or spring. In some embodiments, actuator may be controlled or moved by wire using manual work. In some embodiments actuator 290 may be omitted.
  • seat 288 may be configured to be manually actuated or tilted. In some embodiments, seat 288 may be configured to be positioned in affixed number of angles relative to shaft 202 and/or dock. In other embodiments, seat 288 may be configured to
  • 1195 be repositioned in an infinite number of angled positions relative to shaft 202 and/or dock.
  • Means for delivering ultrasonic energy 297 may be located in/on in/on dock wall 285 of dock 284.
  • Ultrasonic means 297 may be configured to for example, heat fluids: aid in the cleaning of one or more portions of the TD including for example dock 284: aid in the mixing of reagents and/or organic chemicals and/or biomolecules; aid in the fixation of biomolecules and/or other substances to receptors and/or
  • the ultrasonic means comprises a piezoelectric ceramic.
  • the piezoelectric ceramic may measure about 2mm x 2mm x 4mm. It is contemplated that in alternative embodiments, ultrasonic means 297 may be omitted.
  • the piezoelectric ceramic is made from lead zirconate titanate piezoelectric ceramic (which may be sold as PZT8 or PZT4 by
  • the piezoelectric may comprise quartz and/or barium titanate and/or film polymer polyvinylidene fluoride.
  • the ultrasonic means measures between 1 mm and 20mm in any dimension. Some embodiments may comprise a plurality of ultrasonic means. In some embodiments, ultrasonic means may be configured to
  • a portion of ultrasonic means 297 is positioned on an upper surface of shaft 202 and a second portion of ultrasonic means 297 is positioned along dock wall 285 which intersects the upper surface of shaft 202.in the depicted embodiment wall 285 intersects the top surface of shaft 202 at a substantially perpendicular angle.
  • positioning the seat 288 and/or sensors 289 at one or more angles while the cover is in the open position may allow sensor(s) 289 to increase and/or alter contact and/or friction to facilitate a desired reaction between sensor 289 passing tissues and/or fluids.
  • positioning the seat 288 and/or sensors 289 at least at a substantially parallel angle with shaft 202 may be desirable or at least suitable for some applications.
  • one or more suction/vacuum ports 217 may be provided on or about the tip or distal shaft.
  • the port(s) may be fluidly coupled with a vacuum; the vacuum may comprise a pump or a negative pressure chamber or a syringe at the end of a fluid conduit.
  • Other embodiments may comprise one or more suction/vacuum ports on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • a fluid delivery port 216 may be provided on or about the tip or distal shaft.
  • the port(s) may be fluidly coupled with a vacuum; the vacuum may comprise a pump or a negative pressure chamber or a syringe at the end of a fluid conduit.
  • Other embodiments may comprise one or more suction/vacuum ports on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • a fluid delivery port 216 may be provided on or about
  • the fluid delivery port may be coupled with a pump or high pressure fluid.
  • the port may be perpetually open such that fluid may be delivered therethrough upon actuation of a pump or fluid pressure system.
  • the port may be closed and selectively opened to deliver fluid therethrough.
  • Other embodiments may comprise one or more fluid ports on any other suitable location on the TD, including but not limited to on the protrusions or
  • Fluid ports that may be useful may comprise channels within the TD, polymer lines, hoses, etc. Fluids that may emanate from the outlet may comprise ionic fluids such as saline, medicines (including but not limited to antibiotics, anesthetics, antineoplastic agents, bacteriostatic agents, etc.), non-ionic fluids, and or gasses (including but not limited to nitrogen, argon, air, etc.). In some embodiments fluids may be under higher pressures or sprayed. It should be understood that although
  • 218 represents an antenna, such as an RFID TAG or Bluetooth antenna configured to deliver a signal to a receiver unit.
  • antenna 218 comprises an RFID TAG
  • the RFID tag may comprise an RFID transponder. In other embodiments the RFID tag may comprise
  • antenna 218 is not depicted in every one of the other figures, any of the embodiments described herein may comprise one or more such elements. Other embodiments may comprise one or more antenna(s) on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft. In embodiments wherein antenna(s) 218 comprises an RFID transponder such transponder may comprise a microchip, such as a microchip having
  • the tag may measure less than a few millimeters.
  • a reader may generate an alternating electromagnetic field which activates the antenna, such as an RFID transponder, and data may be sent via frequency modulation.
  • the position(s) of the RFID tag(s) or other antenna may be determined by an alternating electromagnetic field in the ultra-high frequency range. The position may be
  • the reader may generate an alternating electromagnetic field.
  • the alternating electromagnetic field may be in the shortwave (13.56MHz) or UHF (865-869MHz) frequency.
  • Examples of potentially useful systems and methods for mapping/tracking a surgical instrument in relation to a patient's body may be found in U.S. Patent Application Publication No. 2007/0225550 titled "System and Method for 3-D Tracking of Surgical
  • a transmission unit may be provided that may generate a high-frequency electromagnetic field configured to be received by an antenna of the RFID tag or another antenna.
  • the antenna may be configured to create an inductive current from the electromagnetic field. This current may activate a circuit of the tag, which may result in transmission of electromagnetic radiation from the tag.
  • this may be accomplished by modulation of the field created by the transmission unit.
  • the frequency of the electromagnetic radiation emitted by the tag may be distinct from the radiation emitted from the transmission unit. In this manner, it may be possible to identify and distinguish the two signals.
  • the frequency of the signal from the tag may lie within a side range of the frequency of the radiation emitted from the transmission unit. Additional details regarding RFID technology that may be
  • antenna 218 may comprise a Bluetooth antenna.
  • multiple corresponding Bluetooth receivers at known locations may be configured to sense signal strengths
  • Bluetooth antenna 218 triangulate such data in order to localize the signal from the Bluetooth antenna 218 and thereby locate the TD within a patient's body.
  • Other embodiments may be configured to use angle-based, electronic localization techniques and equipment in order to locate the antenna 218. Some such embodiments may comprise use of directional antennas, which may be useful to increase the accuracy of the localization. Still other embodiments may comprise use of other types of hardware and/or
  • signals that may be useful for localization such as WIFI and cellular signals, for example.
  • One or more receiver units may be set up to receive the signal from the tag. By evaluating, for example, the strength of the signal at various receiver units, the distances from the various receiver units may be determined. By so determining such distances, a precise location of the TD relative to a patient and/or a particular organ or other surgical site on the patient may be determined. In some embodiments, a
  • Some embodiments may be further configured such that data from the antenna(s) may be used in connection with sensor data from the TD.
  • data from the antenna(s) may be used in connection with sensor data from the TD.
  • TDs comprising one or
  • sensors 1285 more sensors may be further configured with one or more RFID tags or other antenna(s).
  • data from the one or more sensors may be paired or otherwise used in connection with data from the one or more antenna(s).
  • some embodiments may be configured to provide information to a surgeon regarding one or more locations on the body from which one or more sensor readings were obtained.
  • information regarding tissue concentration of a particular protein may be provided.
  • nucleic acid 1290 and/or nucleic acid may be combined with a location from which such tissue concentration(s) were taken.
  • a surgeon may be provided with specific information regarding which locations within a patient's body have been adequately sampled or otherwise found to contain the concentrations referenced aboveTD.
  • a visual display may be provided comprising an image of the patient's 1295 body and/or one or more selected regions of a patient's body.
  • a system may be configured so as to provide a visual indication for one or more regions within the image corresponding to regions of the patient's tissue that have been sufficiently analyzed.
  • a display of a patient's liver may change colors at locations on the display that correspond with regions of the liver that have been detected to contain a specified range of hepatitis virus.
  • regions may, in some embodiments, be configured such 1300 that pixels corresponding to particular regions only light up after the corresponding tissue in that region reaches a particular threshold concentration.
  • tip 201 may be attached to a robotic arm. In some embodiments, tip 201 and portion of shaft 202 may be attached to a robotic arm. In some embodiments tip 201 and/or a portion of shaft 202 and/or a portion shaft and/or portion of handle 203 may be attached to a robotic arm. In some embodiments
  • the robotic arm may comprise one or more motors such as a screw-drive motor, gear motor, hydraulic motors, etc.
  • the robotic arm system may comprise worm gearheads, video cameras, motor control circuits, monitors, remote control devices, illumination sources, tactile interface, etc.
  • Figures 2k and 2L depict alternative embodiments of a TD in which cover 280 comprises one or more openings 280k in Figure 2K and 280L in Figure 2L.
  • cover 280 comprises one or more openings 280k in Figure 2K and 280L in Figure 2L.
  • the remaining elements shown Figures 2k and 21 may
  • cover 280 may be configured to at least substantially seal (other than opening(s) 280k) an interior space such that a vacuum applied via port 287 may result in suction through opening 280k.
  • the opening(s) 280k may have a round shape. In the depicted embodiment,
  • openings 280k may measure about 1.5mm in diameter. In other embodiments, openings 280k may range in diameter from about 100 microns to about 100mm. In other contemplated embodiments, openings 280k may have a variety of geometric shapes including but not limited to square, rectangular, and/or polygonal. In the depicted embodiment, sensor 289k may comprise a optical sensor. In some embodiments, cover 280 may be configured to at least substantially seal an interior space such that a vacuum applied via port
  • seat 288 may elevate or decline to allow sensor 289k to approach and/or move away from opening 280k in order to increase and/or decrease contact with tissues and/or fluids that may be suctioned into the space inside of cover 280 and dock 284 when suction is applied via suction port 287.
  • Actuators not seen in this view but discussed elsewhere in this disclosure may be configured to move seat 288 and/or sensor 289k.
  • fluids and/or tissues external to cover 280 may be forced/pulled into contact with the edges of openings 280k and these may be further pulled through openings 280k with or without gross movement of the TD. Fluids and/or tissues that were previously external to the TD may be brought into contact with sensor 289k for analysis. Elements within the dock and cover space, not seen in this view but discussed elsewhere in this disclosure may be configured to move, stir, and/or alter the temperature of
  • Fluid entry into cover 280 may be facilitated or prevented by several factors including but not limited to size of openings, outside environment, tissue environment, and/or positive pressure of fluids/gasses from fluid delivery port 286 and/or vacuum from fluid extraction port 287.
  • the shaft of FIG. 2k further comprises antenna 218k.
  • 218k represents
  • antenna 1335 an antenna configured to deliver a signal to a receiver unit.
  • antenna 218k may comprise any of the antennas described elsewhere herein including for example any of the antennas discussed in connection with antenna 218k.
  • antenna 218k comprises an RFID tag
  • the RFID tag may comprise an RFID transponder.
  • At least one opening 280L is/are present in cover 280. In the depicted
  • opening(s) 280L may have a round shape. In the depicted embodiment, openings 280L may measure about 1.5mm in diameter. In the embodiment depicted in Fig. 2L, at least a portion of sensor 289L is allowed to protrude through a portion of the TD into the space external to the TD for body tissue and/or fluid sensing and/or sampling and/or testing. In other embodiments, openings 280L may range in diameter from about 100 microns to about 100mm. In other contemplated embodiments openings 280L 1345 may have a variety of geometric shapes including but not limited to square, rectangular, and/or polygonal. For example, a rectangular shaped opening may allow for sensors deployed on a strip to pass through the opening.
  • Sensors 289L deployed on a strip may pass through opening(s) 280L, as shown in Figure 2L.
  • a strip seen from the side view may look like a line.
  • the sensors and/or the material, that said sensors are deployed upon are flexible. Flexibility may be helpful to maintain integrity of a sensor
  • sensor 289L is an optical sensor.
  • cover 280 may be configured to at least substantially seal an interior space such that a vacuum applied via port 287 may result in suction through opening(s) 280L.
  • at least a portion of a sensor may protrude through an opening 280L in the TD to make contact with tissues and/or fluids outside of the TD.
  • seat 288 may elevate or decline to allow sensor 289L to pass through opening 280L in order to contact tissues and/or fluids outside the cover and/or dock and/or TD and/or return back into the area under the cover adjacent to the dock.
  • Actuators not seen in this view but discussed elsewhere in this disclosure may be configured move seat 288 and/or sensor 289L. Fluid entry into cover 280 may be facilitated or prevented by several factors including but not limited to size of openings, outside environment,
  • Sensor 289L may receive and/or send one or more signals from and/or back to a processing unit to be analyzed while deployed outside of the cover and/or once retracted back under the cover. After sensor 289L is retracted back through the cover, it may be cleaned as discussed elsewhere in this disclosure.
  • Sensor 289L may be coupled with an antenna, which may send and/or receive one or more signals to/from a processing unit while sensor 289L is deployed outside of cover 280.
  • data from sensor 289L resulting from tissue and/or fluid analysis using sensor 289L may be stored locally and transmitted later.
  • a signal including such analysis data may be transmitted after sensor 289L has been retracted back under cover 280.
  • such a signal may be
  • the signals need not necessarily be transmitted wirelessly.
  • some embodiments may be configured to store data locally, after which a data module, such as a memory stick, may be removed from the TD TDM and uploaded to a separate computer for analysis.
  • the shaft of FIG. 2L further comprises antenna 218L.
  • 218L represents an 1375 antenna configured to deliver a signal to a receiver unit.
  • antenna 218L may comprise any of the antennas described elsewhere herein including for example any of the antennas discussed in connection with antenna 218L.
  • the RFID tag may comprise an RFID transponder.
  • tip 201 may be made of materials that are both electrically non-conductive and of low thermal conductivity such as porcelain, epoxies, ceramics, glass- ceramics, plastics, or varieties of polytetrafluoroethylene.
  • the tip may be made from metals or electroconductive materials that are completely or partially insulated. Note the relative protrusions and relative recessions are not completely visible from this viewing angle.
  • the relative 1385 recessions of the tip is the electrically conductive tissue lysing element 205 (usually hidden from view at most angles) which may have any geometric shape including a thin cylindrical wire; the electrically conductive lysing element can be in the shape of a plate or plane or wire and made of any metal or alloy that does not melt under operating conditions or give off toxic residua.
  • Optimal materials may include but are not limited to steel, nickel, alloys, palladium, gold, tungsten, silver, copper, and platinum. Metals may
  • the geometry of the tip area may comprise protrusions that are not oriented along the axis of the shaft (as seen from a top view); some of these alternative embodiments for tip area geometries are depicted in Figures 5a,b,c,d.
  • Some embodiments may be configured to be modular and/or comprise disposable tips such that a surgeon can place an appropriate tip for a particular surgery on the shaft.
  • one or more of the tip area may comprise protrusions that are not oriented along the axis of the shaft (as seen from a top view); some of these alternative embodiments for tip area geometries are depicted in Figures 5a,b,c,d.
  • Some embodiments may be configured to be modular and/or comprise disposable tips such that a surgeon can place an appropriate tip for a particular surgery on the shaft.
  • the 1395 of the tips may be disposable such that a surgeon may dispose of the tip after performing surgery and install a new tip for subsequent surgeries or a continuation of the current surgery with a new tip.
  • An energy window 207 may be present on the upper side of the device. It is contemplated that in alternative embodiments, energy window 207 may be omitted. It should be noted that the term "energy window" is intended to encompass what is referred to as a planar-tissue-altering-window/zone in U.S.
  • the "energy window” may comprise a variety of other energy emitting devices, including radiofrequency, intense pulsed light, LASER, thermal, microwave and ultrasonic. It should also be understood that the term “energy window” does not necessarily imply that energy is delivered uniformly throughout the region comprising the energy window. Instead, some energy window implementations may
  • a second energy window may also be included in some embodiments,
  • the 1410 may comprise an ultrasound emitter or another variety of energy emitting device.
  • Electro-cutting energy may arrive in conduits 211 and/or 212.
  • the tip may measure about 1cm in width and about 1 -2 mm in thickness. Sizes of about one-fifth to about five times these dimensions may also have possible uses. In some veterinary embodiments, tip sizes of about one-tenth to 20 times the aforementioned dimensions may also have
  • the tip can be a separate piece that is secured to shaft by a variety of methods such as a snap mechanism, mating grooves, plastic sonic welding, etc.
  • the tip can be integral or a continuation of shaft made of similar metal or materials.
  • the tip may also be constructed of materials that are both electrically non-conductive and of low thermal conductivity; such materials might comprise, for example, porcelain, ceramics, glass-
  • the tip may be constructed of a support matrix of an insulating material (e.g., ceramic or glass material such as alumina, zirconia). Lysing segment energy conduit 211 connects to electrically conductive elements to bring RF electrosurgical energy from an electrosurgical generator down 1425 the shaft 202 to electrically conductive lysing elements 205 mounted in the recessions in between the protrusions 204.
  • the protrusions may comprise bulbous protrusions.
  • the tip shown in this embodiment has four relative protrusions and three relative recessions and provides for a monopolar tip conductive element.
  • All of the axes of the relative protrusions of the tip depicted in this embodiment extend at least substantially parallel to the axis of the shaft of the TD (as viewed from Top).
  • surgeons may use methods of defining and or dissecting a target area by entering through an incision and then moving the TD tip in a primarily axial direction forward and backward and reorienting the TD after the backstroke in a spokewheel pattern the TD to access tissues adjacent to earlier strokes.
  • some of the protrusions and lysing segments may be oriented in a non-axial direction.
  • the tip 201 may alternatively be made partially or completely of concentrically laminated or annealed-in wafer layers of materials that may include plastics, silicon, glass, glass/ceramics, cermets or ceramics. Lysing elements 205 may also be made partially or completely of a cermet material. Alternatively, in a further embodiment the tip may be constructed of insulation covered metals or electroconductive materials.
  • the shaft may be flat, rectangular or 1440 geometric in cross-section or substantially flattened. In some embodiments, smoothing of the edges of the shaft may reduce friction on the skin surrounding the entrance wound.
  • the shaft may be made of metal or plastic or other material with a completely occupied or hollow interior that can contain insulated wires, electrical conductors, fluid/gas pumping or suctioning conduits, fiber-optics, or insulation.
  • the shaft may have a length of about 10-20cm. In some embodiments the handle may have a length of about 8-18cm.
  • shaft plastics such as polytetrafluoroethylene may act as insulation about wire or electrically conductive elements.
  • the shaft may alternatively be made partially or completely of concentrically laminated or annealed-in wafer layers of materials that may include plastics,
  • the energy window 207 may only be substantially planar, or may take on other cross-sectional shapes that may correspond with a portion of the shape of the shaft, such as arced, stair-step, or other geometric shapes/curvatures. In the embodiments depicted in FIGS. 2a & 2b, energy window 207 is adjacent to protrusions 204, however other embodiments are contemplated in which an energy window may be
  • Conduits may also contain electrical control wires to aid in device operation. Partially hidden from direct view in FIGS. 2a & 2b, and located in the grooves defined by protrusions 204 are electrically
  • conductive tissue lysing elements 205 which, when powered by an electrosurgical generator, effects lysing of tissue planes on forward motion of the device.
  • the lysing segments may be located at the termini of conductive elements.
  • one or more sensors such as for example sensors 210 and 214 may be positioned on the device.
  • the sensors 210 and 214 may comprise any of the sensors described in the specification herein. Other embodiments may comprise one or more sensors on any other
  • TD suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • Sensors that may be useful include thermal sensors, photoelectric or photo optic sensors, cameras, etc.
  • one or more sensors may be used to monitor the local post passage electrical impedance or thermal conditions that may exist near the distal tip of the shaft or on the tip.
  • Some embodiments may also comprise one or more sensors incorporating MEMS (Micro Electro-Mechanical
  • sensor 1470 Systems such as MEMS gyroscopes, accelerometers, and the like.
  • sensors may be positioned at any number of locations on the TD, including within the handle in some embodiments.
  • sensor 214 may comprise fiberoptic elements.
  • the sensor can be configured to sense a temperature of tissue adjacent to the apparatus.
  • the temperature sensor may alternatively be configured or sense a temperature of one or more fluids adjacent to the apparatus such as
  • tissue fluids and/or fluids introduced by the surgeon for example tissue fluids and/or fluids introduced by the surgeon.
  • Temperature and impedance values may be tracked on a display screen or directly linked to a microprocessor capable of signaling control electronics to alter the energy delivered to the tip when preset values are approached or exceeded.
  • Typical instrumentation paths are widely known, such as thermal sensing thermistors, and may feed to analog amplifiers which, in turn, feed analog digital converters
  • internal or external ultrasound measurements may also provide information which may be incorporated into a feedback circuit.
  • an optional mid and low frequency ultrasound transducer may also be activated to transmit energy to the tip and provide additional heating and may additionally improve lysing.
  • a flashing visible light source for example, an LED, can be mounted on the tip may show through the tissues and/or organs
  • one or more electromagnetic delivery elements 215 may be positioned on tip or shaft.
  • Other embodiments may comprise one or more electromagnetic delivery elements on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • Electromagnetic delivery elements that may be useful include: LEDs, LASERS, fiberoptics,
  • a second energy window 208 may also be included in some embodiments, and may comprise yet another ultrasonic energy emitter or another variety of energy emitting device.
  • An ultrasonically energized energy window 208 may be present on the upper side of the device. It is contemplated that in alternative embodiments, energy window 208 may be omitted. It should be noted that the term "energy window" is
  • the "energy window” may comprise a variety of other energy emitting devices, including ultrasonic, intense pulsed light, LASER, thermal, microwave and electrical. It should also be understood that the term “energy window” does not necessarily imply that energy is delivered uniformly throughout the
  • some energy window implementations may comprise a series of energy delivering elements or other regions within which energy is delivered with interspersed regions within which no energy, or less energy, is delivered.
  • An ultrasonic energy window configuration may be useful for some implementations, depending upon piezoelectric component and/or energy applied to less aggressively disrupt tissues (in order to possibly increase the concentration of target chemicals
  • Energy window 208 may only be at least substantially planar, or may take on other cross-sectional shapes that may correspond with a portion of the shape of the shaft, such as arced, stair-step, or other geometric shapes/curvatures.
  • Some embodiments may comprise a low cost, disposable, and one-time-use device.
  • the tip's electrically conductive tissue lysing elements be protected or coated with materials that include, but are not limited to, SilverglideTM non-stick surgical coating, platinum, palladium, gold and rhodium. Varying the amount of protective coating allows for embodiments of varying potential for obsolescence capable of either prolonging or shortening instrument 1515 life.
  • the electrically conductive lysing element portion of the tip may arise from a plane or plate of varying shapes derived from the aforementioned materials by methods known in the manufacturing art, including but not limited to additive manufacturing, cutting, stamping, pouring, molding, filing and sanding.
  • the electrically conductive lysing element 205 may comprise an 1520 insert attached to a conductive element in the shaft or continuous with a formed conductive element coursing all or part of the shaft.
  • a lysing segment energy conduit 211 brings RF electrosurgical energy down the shaft to electrically conductive lysing elements 205 associated in part with the recessions.
  • the electrosurgical energy via conduit 211 is predominately electro- cutting.
  • the electrically conductive element or wiring may be bifurcated to employ hand switching if an optional finger switch is located on handle.
  • the electrically conductive element or wiring leading from the shaft into the handle may be bundled with other leads or energy delivering cables, wiring and the like and may exit the proximal handle as insulated general wiring to various generators (including electrosurgical), central processing units, lasers and other sources as have been described herein.
  • generators including electrosurgical
  • central processing units including lasers and other sources as have been described herein.
  • the plate making up lysing segments 205 may be sharpened or scalloped or made to slightly extend outwardly from the tip recessions into which the plate will fit.
  • the lysing element may be recessed into the relative recessions or grooves defined by the protrusions 204 or, alternatively, may be flush with protrusions 204.
  • locations of the electrically conductive lysing elements with respect to the protrusions may be adjusted by diminutive screws or ratchets. In some further adjustable embodiments, locations of the electrically conductive lysing elements with respect to the protrusions may be adjusted by MEMS or microelectronics.
  • the plate which in some embodiments is between 0.01 mm and 1 mm thick, can be sharpened to varying degrees on its forward facing surface. It is possible that plate sharpness may
  • the plate thickness may vary from 0.001 mm to 3mm thick.
  • the electrically conductive lysing element may also exist in the shape of a
  • an electrosurgical current for the electrically conductive lysing element is of the monopolar "cutting" variety and setting and may be delivered to the tip lysing conductor in a continuous fashion or,
  • the electrically conductive lysing element is a monopolar tip in contact with conductive elements in the shaft leading to external surgical cable leading to an electrosurgical generator from which 1555 emanates a grounding or dispersive plate which may be placed elsewhere in contact with the patient's body, such as the thigh.
  • Such circuitry may be controlled and gated/wired from the cutting current delivery system of the electro surgical generator.
  • the tip may also be manufactured from multilayer wafer substrates comprised of bonded conductive strips and ceramics. Suitable conductive materials include but are not limited to those already described for tip manufacture.
  • the electrically conductive lysing elements may be bifurcated or divided into even numbers at the relative recessions, insulated and energized by wiring to an even number of leads in a bipolar fashion and connected to the bipolar outlets of the aforementioned electrosurgical generators. Rings partly or completely encircling the shaft of the hand unit can be linked to a partner bipolar electrode at the tip or on the energy window. Such bipolar versions may decrease the available power necessary to
  • the lysing elements may be divided into odd numbers yet still allow for bipolar flow between two or more elements as those of ordinary skill in the art would appreciate.
  • Figures 3a-j depict various views of a particular embodiment of a tissue dissector (TD) with a sensor dock on the upper side of the device with a movable cover.
  • TD tissue dissector
  • FIG. 3a is a perspective view of an embodiment of a TD comprising a tip 301 lacking protrusion and lysing segments, a shaft 302, a handle 303.
  • tip 301 is radiused and blunt.
  • the depicted embodiment also lacks cutting current availability on the tip.
  • An ultrasonically energized energy window 307 may be present on the upper side of the device. It is contemplated that in alternative embodiments, energy window 307 may be omitted. It should be noted that the term "energy window" is
  • the "energy window” may comprise a variety of other energy emitting devices, including radiofrequency, intense pulsed light, LASER, thermal, microwave and electrical. It should also be understood that the term “energy window” does not necessarily imply that energy is delivered uniformly
  • some energy window implementations may comprise a series of energy delivering elements or other regions within which energy is delivered with interspersed regions within which no energy, or less energy, is delivered.
  • An ultrasonic energy window configuration may be useful for some implementations, depending upon piezoelectric component and/or energy applied to less aggressively disrupt tissues (in order to possibly increase the concentration of target
  • a second energy window may also be included in some embodiments, and may comprise a microwave emission device or another variety of energy emitting device. In some contemplated embodiments, one or more energy windows may be present
  • Energy window 307 may only be at least substantially planar, or may take on other cross-sectional shapes that may correspond with a portion of the shape of the shaft, such as arced, stair-step, or other geometric shapes/curvatures.
  • Ultrasonic Energy Window 307 may be configured to for example, disrupt cells to release chemicals and/or biomarkers and/or heat target tissues and/ or fluids. In the depicted embodiment, Ultrasonic Energy
  • Window 307 comprises a piezoelectric ceramic.
  • the piezoelectric ceramic may measure about 20mm x 8mm x 3mm. In some embodiments, the piezoelectric ceramic may measure up to about 50mm in diameter. It is contemplated that in alternative embodiments, Ultrasonic Energy Window 307 may be omitted.
  • the piezoelectric ceramic is made from lead zirconate titanate piezoelectric ceramic (which may be sold as PZT8 or PZT4 by Micromechatronics, State College,
  • the piezoelectric may comprise quartz and/or barium titanate and/or film polymer polyvinylidene fluoride.
  • the ultrasonic energy window measures between 1 mm and 50mm in any dimension. Some embodiments may comprise a plurality of ultrasonic energy windows. Depending upon the composition of a piezoelectric and/or the surrounding environment and/or the structure(s) in which the piezo is mounted, a given mounted piezoelectric ceramic may have one
  • frequency ranges and energy ranges that may be beneficial in disrupting target cells to a limited degree may be within a frequency range of about 25 to 40kiloHertz with energy level ranges of about 3-10 Watts and/or 10-30 Volts.
  • application time ranges of about 5-60 seconds may be possible to lyse some target cells.
  • window 307 may be used to heat and/or treat and/or damage target
  • window 307 may be used to heat and/or treat and/or damage target tissues by applying a higher energy level with energy parameters that may range to about 10-20 Watts and/or 30-50 Volts. Examples of ultrasound technology that may be useful for some of the embodiments disclosed herein such as for ultrasonic energy windows 307 and/or 308 may be found in Miniaturized Ultrasound Arrays for
  • an ultrasonic energy window may be provided that is configured to allow for selective adjustment of one or more such parameters, including power, voltage, and/or frequency, as described above. This may be useful to, for example, allow a surgeon to use higher energy/power to access a desired tissue/organ, such as to get through investing fibrous tissues adjacent an organ by
  • some embodiments may be configured with two separate ultrasonic energy windows. One such window may be configured to deliver relatively high power/energy,
  • the other such window may be configured to deliver relatively low power/energy.
  • an ultrasonic energy window may be used in a procedure to agitate and/or disrupt a biofilm. Since microorganisms making up a biofilm typically have significantly different properties from free-floating bacteria or other microorganisms, such disruption may be useful to allow for sampling and/or analysis of microorganisms making up the biofilm that may have been difficult or impossible without
  • ultrasonic energy windows 307 and 308 examples of ultrasound technology that may be useful for some of the embodiments disclosed herein such as for ultrasonic energy windows 307 and 308 may be found in Rapid Skin Permeablization by the Simultaneous Application of Dual Frequency, High-Intensity Ultrasound (Schoelhammer, Polat, Mendenhall, Langer, et al; Journal of Controlled Release, 2012, 163(2):154-160.) and Ultrasonic Mediated
  • FIG. 3a a perspective view of an embodiment of a TD comprising a tip 301 , a shaft 302 and a handle 303); located on the shaft 302 is dock 384 that may accommodate seat 388 which may releasably hold sensor 389.
  • sensor 389 may comprise a nanosensor.
  • dock 384 may be recessed into shaft 302 and/or tip 301. In some embodiments dock 384
  • sensor 389 may comprise a silicon nanowire sensor. In some embodiments the sensor 389 may comprise a biological nanosensor. In some embodiments, nanosensor 189 may comprise a conducting polymer and/or glass and/or polymer and/or plastic and/or graphene and/or carbon, etc.. In some embodiments, seat 388 may be fixed in position. In some embodiments,
  • seat 388 may be moveable.
  • sensor 384 may be fixed in seat 188.
  • the sensor 389 may be detachable seat 388. It is contemplated that in alternative embodiments, seat 388 may be omitted.
  • the dock may comprise cover moving means and/or a cover tip. Cover tip 381 and means for selectively moving a cover 383 may be positioned adjacent dock 184. Examples of such cover moving means may include rails, grooves, tracks, ratchets,
  • cover moving means comprises a rail.
  • a portion of the shaft may comprise cover moving means 383.
  • cover moving means 383 may be omitted.
  • Dock 384 may comprise one or more dock wall(s) 385.
  • Dock wall 385 may comprise fluid delivery port 386 for fluid delivery conduit.
  • Dock wall 385 may comprise fluid extraction port 387 for fluid extraction conduit.
  • 1690 385 may comprise one or more ports 386 and/or 387.
  • cover 380 is moveable along cover moving means 383 and may be opened or closed via internal control wires. In some embodiments the cover may be moved by motors.
  • Rear end of cover 382 may be fixed to cover 380. In some embodiments, rear end of cover 382 is not fixed to cover and is itself attached to another portion of the TD.
  • dock 384 and/or dock wall 385 may accommodate a temperature modification
  • Temperature modification means 395 for modifying a temperature within the dock 384 and cover 380.
  • Temperature modification means 395 may comprise, for example a heater, a Peltier cooler, a heat pump, etc. Temperature modification means 395 may be used to heat fluids introduced by way of port 386. Temperature modification means 395 may alternatively be used to heat tissues and/or other fluids such as body tissues and/or fluids captured during a procedure using the TD. In some embodiments temperature modification
  • means 395 may facilitate and/or inhibit certain chemical reactions and/or bond alterations that may be needed in order to sense certain biomaterials using sensor 389.
  • dock 384 and/or dock wall 385 may accommodate mixing element 396.
  • temperature modification means 395 may comprise an electrical resistance heater.
  • heater 395 may comprise a thin film resistor and/or piezoelectric heating device and/or other device capable of heating
  • mixing element 396 may comprise a propeller driven by an electric motor.
  • mixing element 396 may comprise one or more flaps of relatively inert flexible polymeric plastic on a post spun by an electric motor. Examples of other materials for such a flap may include polymers, metals, ceramics, etc.
  • mixing element 396 may comprise an unattached stirring rod spun by oscillating magnet. In a contemplated embodiment, a separate set of ports
  • 1710 may originate and terminate in dock 384, and may be connected by conduit which is fluidly coupled with a piezoelectric pump and/or another fluidic motor and/or another fluidic driving device.
  • a piezoelectric pump and/or another fluidic motor and/or another fluidic driving device may be positioned at an opposite end of dock 384 such that delivery of fluid(s) and/or application of a vacuum may be applied more evenly throughout dock 384.
  • 1715 element 396 may be omitted.
  • One or more sensors 378 and/or 379 may be located on dock 384. In some embodiments, one or more sensors 378 and/or 379 may be located on dock wall 385 and/or cover 380. Sensors 378 and/or 379 may comprise any of the specific examples of sensors discussed in connection with sensors 310 and/or 314. Sensor(s) 378 and/or 379 may report conditions and/or changing conditions in dock area 384 in and/or around nanosensor 389.
  • Nanosensors may be obtained/manufactured by methods available to those of ordinary skill in the art, including but not limited to: U.S. Patent No. 8,022,444 B2 titled “Biosensor and Method of Manufacturing the Same,” and/or U.S. Patent No. 8,314,357 B2 titled “Joule Heated Nanowire Biosensors,” and/or U.S. Patent No. 8,236,595 B2 titled “Nanowire Sensor, Nanowire Sensor Array and Method of Fabricating the Same,” and/or Label Free DNA Sensor Using a Silicon Nanowire Array (Kulkarni, Xu, Ahn, Amin, et.al.; J
  • some of the reagents and/or chemicals and/or biochemicals that may be present in and/or delivered to and/or removed from the dock area to facilitate sensor use and/or cleaning, etc. may include but not be limited to ethanolic solutions, thiols, SDS (sodium dodecyl sulfate), water, argon gas, sodium chloride, sodium bicarbonate buffer, EGTA (ethylene glycol tetraacetic acid), EDTA (ethylenediaminetetraacetic acid), sulfo-NHS diazirine (sulfo-SDA), PBS (phosphate buffered saline),
  • sensor 378 and or sensor 379 may comprise a camera. In some embodiments,
  • 1775 sensor 378 and or sensor 379 may comprise a fiberoptic and/or fiberoptic camera and/or CCD camera and/or other camera.
  • one or more electromagnetic delivery elements 377 may be positioned on dock 384 tip and/or cover 380 and/or tip of cover 381.
  • Other embodiments may comprise one or more electromagnetic delivery elements on any other suitable location on the TD, including but not limited to on
  • Electromagnetic delivery elements that may be useful include but are not limited to: LEDs, LASERS, fiberoptics, filaments, photoelectric materials, infrared emitters, etc.
  • emission of such electromagnetic energy may be absorbed by a chemical and/or biomolecule on the sensor and/or dock area and/or reflectance and/or emission spectra of the chemical and/or biomolecule and/or a further product may be detected via sensors 378 and/or 379.
  • cover 380 and/or dock 384 may be configured to reflect electromagnetic radiation.
  • cover 380 and/or dock 384 comprise a thin film coating over a substrate.
  • the substrate may be plastics and/or molded polymer and/or crystal and/or glass and/or metal, etc.
  • cover 380 and/or dock may be plastics and/or molded polymer and/or crystal and/or glass and/or metal, etc.
  • the 1790 384 comprise a coating of aluminum.
  • the aluminum coating comprises a protected aluminum and/or enhanced aluminum and/or UV-enhanced aluminum (a maker may be Edmund Optics, Barrington, NJ, USA).
  • cover 380 may comprise plastic. In other embodiments cover 380 may comprise materials including but not limited to: polymers, quartz, glass, carbon based materials, silicates 1795 and/or metals.
  • one or more sensors such as for example sensors 310 and 314 may be positioned on the device.
  • the sensors 310 and 314 may comprise any of the sensors described in the specification herein.
  • sensor 310 and or sensor 314 may comprise a camera.
  • sensor 310 and or sensor 314 may comprise a fiberoptic and/or fiberoptic camera
  • TD TD
  • Sensors that may be useful include thermal sensors, photoelectric or photo optic sensors, cameras, etc.
  • one or more sensors may be used to monitor the local post passage electrical impedance or thermal conditions that may exist near the distal tip of the shaft or on the tip.
  • MEMS Micro Electro-Mechanical Systems
  • sensors may be positioned at any number of locations on the TD, including within the handle in some embodiments.
  • sensor 314 may comprise fiberoptic elements.
  • the sensor can be configured to sense a temperature of tissue adjacent to the apparatus.
  • the temperature sensor may
  • the 1810 alternatively be configured or sense a temperature of one or more fluids adjacent to the apparatus such as for example tissue fluids and/or fluids introduced by the surgeon.
  • Temperature and impedance values may be tracked on a display screen or directly linked to a microprocessor capable of signaling control electronics to alter the energy delivered to the tip when preset values are approached or exceeded.
  • Typical instrumentation paths are widely known, such as thermal
  • thermistors may feed to analog amplifiers which, in turn, feed analog digital converters leading to a microprocessor.
  • internal or external ultrasound measurements may also provide information which may be incorporated into a feedback circuit.
  • an optional mid and low frequency ultrasound transducer may also be activated to transmit energy to the tip and provide additional heating and may additionally improve lysing.
  • a flashing visible light may also be activated to transmit energy to the tip and provide additional heating and may additionally improve lysing.
  • 1820 light source for example, an LED
  • the tip may show through the tissues and/or organs to identify the location of the device.
  • one or more electromagnetic delivery elements 315 may be positioned on tip or shaft. Other embodiments may comprise one or more electromagnetic delivery elements on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on
  • Electromagnetic delivery elements that may be useful include: LEDs, LASERS, fiberoptics, filaments, photoelectric materials, infrared emitters, etc.
  • handle 303 may comprise one or more ports through which various conduits may be passed.
  • a plurality of conduits may be bundled together for convenience if desired.
  • a miscellaneous conduit bundle 399 may be provided. Miscellaneous
  • conduit bundle 399 may comprise, for example, various other conduits, such as conduits for one or more sensors, such as sensors 310 and 314, one or more electromagnetic delivery elements 315, fluid delivery port(s) 316, and/or suction/vacuum ports 317.
  • miscellaneous conduit bundle 399 may comprise one or more additional conduits, such as one or more additional fluid delivery conduits for delivering a fluid, such as a liquid or gas, to port 386 in dock 384 in the TD.
  • Miscellaneous conduit bundle 399 may further
  • 1835 comprise one or more fluid extraction conduits (from port 387 in dock 384) for extracting of fluid to direct the fluid (again, a liquid or gas) to a remote fluid/chemical sensor.
  • the fluid delivery conduit (leading to port 386) may be configured to deliver, for example, buffers, cleansers, quenching agents, reagents, biological compounds, inert compounds, gases. Fluids delivered (by way of a fluid delivery conduit leading to port 386) may be energized, such as heated, ultrasonically
  • 1840 energized may contain detergents, antibodies, drugs, etc.
  • Fluid extraction conduits may not only be used to withdraw fluids to be discarded from the body, but also may be used in a wash circuit to remove fluids introduced by way of fluid delivery conduit leading to port 386 that are used to, for example, wash and/or disinfect certain tissues and/or components of the TD. Fluid extraction conduit (leading from port 387) may also be used to extract
  • Some embodiments may be configured to provide a bubble between separate sets of fluids to allow a user to distinguish between various fluid streams delivered using fluid extraction conduit leading from port 387.
  • a vibration means 370 may be positioned in the handle.
  • Other embodiments may comprise one or more vibration means on any other suitable location on the TD, including but not
  • vibration means may include piezoelectric materials, ultrasonic motors with stators, piezoelectric actuators, vibration motor such as an off-center weight mounted on a gear, etc.
  • Some vibration means may be configured to emit ultrasound in the 20-40kHz range.
  • Yet other vibration means may include electromagnet drivers with a frequency of operation in the range of 150-400Hz.
  • one or more vibration means may include piezoelectric materials, ultrasonic motors with stators, piezoelectric actuators, vibration motor such as an off-center weight mounted on a gear, etc.
  • Some vibration means may be configured to emit ultrasound in the 20-40kHz range.
  • vibration means may include electromagnet drivers with a frequency of operation in the range of 150-400Hz.
  • one or more vibration means may be configured to emit ultrasound in the 20-40kHz range.
  • electromagnet drivers with a frequency of operation in the range of 150-400Hz.
  • a vibration means may, also or alternatively, be used to assist in migrating the TD through tissue during the procedure. In some such embodiments, it is thought that use of a vibration means having a lower frequency may be particularly useful for assisting in such migration. In addition, positioning the vibration means closer to a handle of the TD may facilitate such migration as well.
  • Figures 3 d, c depict the
  • Figures 3 f, e depict the TD with cover 380 moved distally to close over and/or seal dock.
  • FIG. 3g is cross sectional view of an embodiment of cover 380 comprising a groove 391 and projection 392 as described herein.
  • Groove 392 may be used to direct fluids within cover 180 to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations
  • projection 392 may also be used to direct fluids to one or more desired locations and/or agitate fluids in a desired manner for a particular use.
  • FIG. 3h is cross sectional view of an embodiment of dock 384 comprising a groove 393 and a projection 394 as described herein.
  • Groove 393 may be used to direct fluids within dock 384 to facilitate
  • cover 380 and dock 384 may when cover 380 is in a closed position, define a common space. In some embodiments, cover
  • 1875 grooves 391 may operate in conjunction with dock grooves 393 or dock protrusions 394 to impact fluid behavior in a desired manner.
  • one or more grooves 391 and 393 may be provided for example in dock 384 and/or in an interior surface of cover 380 in order to direct fluids delivered through port 386 are directed to desired to one or more desired locations.
  • grooves may be configured to facilitate
  • projections 392 and 394 may be provided for example in dock 384 and/or in an interior surface of cover 380 in order to direct fluids delivered through port 386 are directed to desired to one or more desired locations.
  • projections may be configured to facilitate mixing of fluids and/or directing fluids to locations in need of cleaning and/or directing fluids to sensor locations.
  • multiple projections may define a groove, in other embodiments one or more grooves may be formed within a surface of a cover and/or dock.
  • Closing cover 380 may also facilitate isolation of biological tissues and/or fluids. For example, closure of cover 380 may allow for analysis of tosses and/or fluids while
  • FIG. 1890 preventing contamination by other such tissues and fluids after a sample has been taken. Cleaning may be further facilitated by positioning of the seat and/or sensors at an angle and/or various angles.
  • the configuration depicted in Figure 1 i may be primarily for facilitating capture to tissue and/or fluids for analysis, however some embodiments may be configured to tilt seat 388 toward a rear portion of the TD such that it faces (tilts toward) fluid port 386 to facilitate cleaning of sensor 389.
  • Fluid delivery port 386 for fluid delivery and fluid extraction port 387 for fluid extraction may also serve to deliver and/or remove fluids, for example, including but not limited to reagents and/or analyte(s) and/or eluent(s) and/or eluate(s).
  • fluid delivery from fluid delivery port 386 and/or fluid extraction from fluid extraction port 387 may be linked in a circuit with a pump and/or additional conduit (that is coupled with one or both of the conduits coupled with fluid delivery port 386 and fluid extraction port
  • a pump external to the TD fluidly connected to the circuit between the conduits connecting ports 387 and 386, may be used to move fluids.
  • the available space for fluids between the cover 380 and dock 384 (with space occupying elements) may be derived by measuring an amount of fluid entering and/or exiting
  • Fig. 3i is a side (break away) side view, of of the embodiment previously depicted in FIG. 3a of a TD, illustrating an example of positioning and/or protruding a seat (containing a nanosensor) that may allow for some exposure to passing tissues or fluids.
  • the TD may comprise an actuator 390.
  • actuator 390 may comprise a motor.
  • actuator 390 may comprise one or more such motors such as a screw-drive motor, gear motor, hydraulic motors etc.
  • actuator 390 may comprise worm gearheads, motor control circuits, monitors, remote control devices, etc.
  • actuator 390 may be controlled or moved by wire and/or spring. In some embodiments, actuator may be controlled or moved by wire using manual work. In some embodiments actuator 390 may
  • seat 388 may be configured to be manually actuated or tilted. In some embodiments, seat 388 may be configured to be positioned in affixed number of angles relative to shaft 302 and/or dock. In other embodiments, seat 388 may be configured to be repositioned in an infinite number of angled positions relative to shaft 302 and/or dock.
  • Means for delivering ultrasonic energy 397 may be located in/on in/on dock wall 385 of dock 384.
  • Ultrasonic means 397 may be configured to for example, heat fluids: aid in the cleaning of one or more portions of the TD including for example dock 384: aid in the mixing of reagents and/or organic chemicals and/or biomolecules; aid in the fixation of biomolecules and/or other substances to receptors and/or sensors; aid in the removal of biomolecules and/or other substances to receptors.
  • the ultrasonic means comprises a piezoelectric ceramic.
  • the ultrasonic means comprises a piezoelectric ceramic.
  • piezoelectric ceramic may measure about 2mm x 2mm x 4mm. It is contemplated that in alternative embodiments, ultrasonic means 397 may be omitted.
  • the piezoelectric ceramic is made from lead zirconate titanate piezoelectric ceramic (which may be sold as PZT8 or PZT4 by Micromechatronics, State College, Pennsylvania) and may be driven by 2-5Watts at 10-20Volts and/or may be configured to vibrate at a frequency of 300-500kiloHertz. In some embodiments the piezoelectric may
  • ultrasonic means measures between 1 mm and 20mm in any dimension.
  • ultrasonic means may comprise a plurality of ultrasonic means.
  • ultrasonic means may be configured to be positioned on two or more intersecting surfaces, for example in the embodiment depicted in Fig. 1b a portion of ultrasonic means 397 is positioned on an upper surface of shaft 302 and a second portion of 1935 ultrasonic means 397 is positioned along dock wall 385 which intersects the upper surface of shaft 302. in the depicted embodiment wall 385 intersects the top surface of shaft 1302 at a substantially perpendicular angle.
  • positioning the seat 388 and/or sensors 389 at one or more angles while the cover is in the open position may allow sensor(s) 389 to increase and/or alter contact
  • positioning the seat 388 and/or sensors 389 at least at a substantially parallel angle with shaft 302 may be desirable or at least suitable for some applications.
  • one or more suction/vacuum ports 317 may be provided on or about the tip or distal shaft.
  • the port(s) may be fluidly coupled with a vacuum; the vacuum may comprise a pump or a
  • a fluid delivery port 316 may be provided.
  • the fluid delivery port may be coupled with a pump or high pressure fluid.
  • the port may be perpetually open such that fluid may be delivered therethrough upon
  • the port may be closed and selectively opened to deliver fluid therethrough.
  • Other embodiments may comprise one or more fluid ports on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • Fluid ports that may be useful may comprise channels within the TD, polymer lines, hoses, etc. Fluids that may emanate from the outlet may comprise ionic fluids such as saline, medicines (including
  • 318 represents an antenna, such as an RFID TAG or Bluetooth antenna configured to deliver a signal to a receiver unit.
  • antenna 318 comprises an RFID TAG
  • the RFID tag may comprise an RFID transponder.
  • the RFID tag may comprise a passive tag. It should be understood that antenna 318 is not depicted in every one of the other figures, any of the embodiments described herein may comprise one or more such elements.
  • Other embodiments such as an RFID TAG or Bluetooth antenna configured to deliver a signal to a receiver unit.
  • antenna(s) 318 comprises an RFID transponder
  • transponder may comprise a microchip, such as a microchip having a rewritable memory.
  • the tag may measure less than a few millimeters.
  • a reader may generate an alternating electromagnetic field which activates the antenna, such
  • the position(s) of the RFID tag(s) or other antenna may be determined by an alternating electromagnetic field in the ultra-high frequency range.
  • the position may be related to a 3 dimensional mapping of the subject.
  • the reader may generate an alternating electromagnetic field.
  • the alternating electromagnetic field may be 1975 in the shortwave (13.56MHz) or UHF (865-869MHz) frequency. . Examples of potentially useful systems and methods for mapping/tracking a surgical instrument in relation to a patient's body may be found in U.S. Patent Application Publication No. 2007/0225550 titled "System and Method for 3-D Tracking of Surgical Instrument in Relation to Patient Body, which is hereby incorporated by reference in its entirety.
  • a transmission unit may be provided that may generate a high-frequency
  • the antenna may be configured to create an inductive current from the electromagnetic field. This current may activate a circuit of the tag, which may result in transmission of electromagnetic radiation from the tag. In some embodiments, this may be accomplished by modulation of the field created by the transmission unit.
  • the frequency of the electromagnetic radiation emitted by the tag may be distinct from the radiation emitted
  • the frequency of the signal from the tag may lie within a side range of the frequency of the radiation emitted from the transmission unit. Additional details regarding RFID technology that may be useful in connection with one or more embodiments discussed herein may be found in, for example, U.S. Patent Application Publication No. 2009/0281419 titled "System for Determining the Position of a Medical
  • antenna 318 may comprise a Bluetooth antenna.
  • multiple corresponding Bluetooth receivers at known locations may be configured to sense signal strengths from the Bluetooth antenna 318 and triangulate such data in order to localize the signal from the Bluetooth antenna 318 and thereby locate the TD within a patient's body.
  • Other embodiments may be configured to
  • Some such embodiments may comprise use of directional antennas, which may be useful to increase the accuracy of the localization. Still other embodiments may comprise use of other types of hardware and/or signals that may be useful for localization, such as WIFI and cellular signals, for example.
  • One or more receiver units may be set up to receive the signal from the tag.
  • the strength of the signal at various receiver units, the distances from the various receiver units may be determined. By so determining such distances, a precise location of the TD relative to a patient and/or a particular organ or other surgical site on the patient may be determined.
  • a display screen with appropriate software may be coupled with the RFID or other localization technology to allow a surgeon to visualize at least an approximate location of the tag, and therefore TD, relative to the
  • Some embodiments may be further configured such that data from the antenna(s) may be used in connection with sensor data from the TD.
  • TDs comprising one or more sensors may be further configured with one or more RFID tags or other antenna(s).
  • data from the one or more sensors may be paired or otherwise used in connection with data from the one or
  • some embodiments may be configured to provide information to a surgeon regarding one or more locations on the body from which one or more sensor readings were obtained.
  • information regarding tissue concentration of a particular protein and/or nucleic acid may be combined with a location from which such tissue concentration(s) were taken. In this manner, a surgeon may be provided with specific information regarding which locations within a
  • a visual display may be provided comprising an image of the patient's body and/or one or more selected regions of a patient's body.
  • Such a system may be configured so as to provide a visual indication for one or more regions within the image corresponding to regions of the
  • a display of a patient's liver may change colors at locations on the display that correspond with regions of the liver that have been detected to contain a specified range of hepatitis virus.
  • Such regions may, in some embodiments, be configured such that pixels corresponding to particular regions only light up after the corresponding tissue in that region reaches a particular threshold concentration.
  • tip 301 may be attached to a robotic arm.
  • tip 301 and portion of shaft 302 may be attached to a robotic arm.
  • tip 301 and/or a portion of shaft 302 and/or a portion shaft and/or portion of handle 303 may be attached to a robotic arm.
  • the robotic arm may comprise one or more motors such as a screw-drive motor, gear motor, hydraulic motors, etc.
  • the robotic arm system may comprise worm gearheads, video
  • Figures 3k and 3L depict alternative embodiments of a TD in which cover 380 comprises one or more openings 380k in Figure 3K and 380L in Figure 3L.
  • the remaining elements shown Figures 3k and 3I may be similar or identical to embodiments depicted in Figures 3a-3j.
  • At least one opening 380k is/are present in cover 380.
  • cover 380 may be configured to at least substantially seal (other than opening(s) 380k) an interior space such that a vacuum applied via port 387 may result in suction through opening 380k.
  • the opening(s) 380k may have a round shape.
  • openings 380k may measure about 1.5mm in diameter. In other embodiments, openings 380k may range in diameter from about 100 microns to about 100mm. In other contemplated embodiments, openings 380k
  • 2040 may have a variety of geometric shapes including but not limited to square, rectangular, and/or polygonal.
  • sensor 389k may comprise a nanosensor.
  • cover 380 may be configured to at least substantially seal an interior space such that a vacuum applied via port 387 may result in suction through opening(s) 380k.
  • seat 388 may elevate or decline to allow sensor 389k to approach and/or move away from opening 380k in order to increase and/or
  • Fluid entry into cover 380 may be facilitated or prevented by several factors including
  • the shaft of FIG. 3k further comprises antenna 318k.
  • 318k represents an antenna configured to deliver a signal to a receiver unit.
  • antenna 318k may comprise any of the antennas described elsewhere herein including for example any of the antennas
  • antenna 318k comprises an RFID tag
  • the RFID tag may comprise an RFID transponder
  • opening 380L is/are present in cover 380.
  • the opening(s) 380L may have a round shape.
  • openings 380L may measure about 1.5mm in diameter.
  • openings 380L may range in diameter from about 100 microns to about 100mm.
  • openings 380L may have a variety of geometric shapes including but not limited to square, rectangular, and/or polygonal. For example, a rectangular shaped opening may allow for sensors deployed on a strip to pass through the
  • Sensors 389L deployed on a strip may pass through opening(s) 380L, as shown in Figure 3L.
  • a strip seen from the side view may look like a line.
  • the sensors and/or the material, that said sensors are deployed upon are flexible. Flexibility may be helpful to maintain integrity of a sensor passing through an opening (in the cover and/or TD) into the external environment with or without agitation of the TD.
  • sensor 389L is a nanosensor.
  • 2075 may be configured to at least substantially seal an interior space such that a vacuum applied via port 387 may result in suction through opening(s) 380L.
  • a vacuum applied via port 387 may result in suction through opening(s) 380L.
  • at least a portion of a sensor may protrude through an opening 380L in the TD to make contact with tissues and/or fluids outside of the TD.
  • seat 388 may elevate or decline to allow sensor 389L to pass through opening 380L in order to contact tissues and/or fluids outside the cover and/or dock and/or TD and/or return back into the
  • Actuators not seen in this view but discussed elsewhere in this disclosure may be configured move seat 388 and/or sensor 389L. Fluid entry into cover 380 may be facilitated or prevented by several factors including but not limited to size of openings, outside environment, tissue environment, and/or positive pressure of fluids/gasses from fluid delivery port 386 and/or vacuum from fluid extraction port 387. Sensor 389L may receive and/or send one or more signals from and/or back
  • sensor 389L After sensor 389L is retracted back through the cover, it may be cleaned as discussed elsewhere in this disclosure.
  • Sensor 389L may be coupled with an antenna, which may send and/or receive one or more signals to/from a processing unit while sensor 389L is deployed outside of cover 380.
  • an antenna which may send and/or receive one or more signals to/from a processing unit while sensor 389L is deployed outside of cover 380.
  • 2090 data from sensor 389L resulting from tissue and/or fluid analysis using sensor 389L may be stored locally and transmitted later.
  • a signal including such analysis data may be transmitted after sensor 389L has been retracted back under cover 380.
  • such a signal may be transmitted following surgery.
  • the signals need not necessarily be transmitted wirelessly.
  • some embodiments may be configured to store data locally, after which a data module,
  • sensor 389L After sensor 389L is retracted back into cover 380, it may be cleaned, as discussed elsewhere in this disclosure.
  • at least a portion of sensor 389L may be positioned on a flexible roll and/or may be disposable.
  • some embodiments may comprise one or more flexible 2100 nanosensors 389L positioned on a flexible roll or stack such that portions of the roll/stack may protrude from a portion of cover 380, such as through opening(s) 380L, for analysis.
  • tissue/fluid analysis Once a particular tissue/fluid analysis has been performed, some embodiments may be configured to wind the roll, flip the stack, and/or discard of the used portion of sensor 389L and/or to expose a new portion of sensor 389L for further analysis.
  • used portion(s) of sensor 389L may be stored with the TD TDM and discarded
  • a flexible nanosensor 389L such as a nanosensor on a flexible roll, may protrude from a portion of a TD TDM without being manually extended/retracted through openings 380L.
  • Flexible nanosensors may be obtained/manufactured by methods available to those of ordinary skill in the art, including but not limited to: Fabrication of Nanowire Electronics on Nonconventional Substrates By Water-Assisted Transfer Printing Method (Lee, Kim, Zheng;
  • the shaft of FIG. 3L further comprises antenna 318L.
  • 318L represents an antenna configured to deliver a signal to a receiver unit.
  • antenna 318L may
  • antenna 2115 comprise any of the antennas described elsewhere herein including for example any of the antennas discussed in connection with antenna 318L.
  • antenna 318L comprises an RFID tag
  • the RFID tag may comprise an RFID transponder.
  • An energy window 307 may be present on the upper side of the device. It is contemplated that in alternative embodiments, energy window 307 may be omitted. It should be noted that the term "energy
  • 2120 window is intended to encompass what is referred to as a planar-tissue-altering-window/zone in U.S.
  • the "energy window” may comprise a variety of other energy emitting devices, including radiofrequency, , intense pulsed light, LASER, thermal, microwave and ultrasonic. It should also be understood that the term “energy window” does not necessarily imply that energy is delivered uniformly
  • some energy window implementations may comprise a series of termini or other regions within which energy is delivered with interspersed regions within which no energy, or less energy, is delivered. This configuration may be useful for some implementations to allow for alteration of certain tissue areas with interspersed areas within which tissue is not altered, or at least is less altered. This may have some advantages for certain applications due to the
  • a second energy window may also be included in some embodiments, and may comprise an ultrasonic or another variety of energy emitting device.
  • one or more sensors such as for example sensors 310 and 314 may be positioned on the device.
  • the sensors 310 and 314 may comprise any of the sensors described in the specification herein.
  • Other embodiments may comprise one or more sensors on any other suitable location
  • Sensors that may be useful include thermal sensors, photoelectric or photo optic sensors, cameras, etc.
  • one or more sensors may be used to monitor the local post passage electrical impedance or thermal conditions that may exist near the distal tip of the shaft or on the tip.
  • Some embodiments may also comprise one or more sensors incorporating MEMS (Micro Electro-Mechanical Systems) technology, such
  • sensor 2140 as MEMS gyroscopes, accelerometers, and the like. Such sensors may be positioned at any number of locations on the TD, including within the handle in some embodiments.
  • sensor 314 may comprise fiberoptic elements.
  • the sensor can be configured to sense a temperature of tissue adjacent to the apparatus.
  • the temperature sensor may alternatively be configured or sense a temperature of one or more fluids adjacent to the apparatus such as for example tissue fluids and/or fluids
  • Temperature and impedance values may be tracked on a display screen or directly linked to a microprocessor capable of signaling control electronics to alter the energy delivered to the tip when preset values are approached or exceeded.
  • Typical instrumentation paths are widely known, such as thermal sensing thermistors, and may feed to analog amplifiers which, in turn, feed analog digital converters
  • internal or external ultrasound measurements may also provide information which may be incorporated into a feedback circuit.
  • an optional mid and low frequency ultrasound transducer may also be activated to transmit energy to the tip and provide additional heating and may additionally improve lysing.
  • a flashing visible light source for example, an LED, can be mounted on the tip may show through the tissues and/or organs
  • one or more electromagnetic delivery elements 315 may be positioned on tip or shaft.
  • Other embodiments may comprise one or more electromagnetic delivery elements on any other suitable location on the TD, including but not limited to on the protrusions or otherwise on the tip, and on the shaft.
  • Electromagnetic delivery elements that may be useful include: LEDs, LASERs, fiberoptics,
  • a second energy window 308 may also be included in some embodiments, and may comprise yet another ultrasonic energy emitter or another variety of energy emitting device.
  • An ultrasonically energized energy window 308 may be present on the upper side of the device. It is contemplated that in alternative embodiments, energy window 308 may be omitted. It should be noted that the term "energy window" is
  • the "energy window” may comprise a variety of other energy emitting devices, including ultrasonic, intense pulsed light, LASER, thermal, microwave and electrical. It should also be understood that the term “energy window” does not necessarily imply that energy is delivered uniformly throughout the
  • some energy window implementations may comprise a series of energy delivering elements or other regions within which energy is delivered with interspersed regions within which no energy, or less energy, is delivered.
  • An ultrasonic energy window configuration may be useful for some implementations, depending upon piezoelectric component and/or energy applied to less aggressively disrupt tissues (in order to possibly increase the concentration of target chemicals
  • Energy window 308 may only be at least substantially planar, or may take on other cross-sectional shapes that may correspond with a portion of the shape of the shaft, such as arced, stair-step, or other geometric shapes/curvatures.
  • a second energy window 308 may also be included in some embodiments, and may comprise yet another ultrasonic energy emitter or another variety of energy emitting device.
  • An ultrasonically energized energy window 307 may be present on the upper side of the device. It is contemplated that in alternative embodiments, energy window 307 may be omitted.
  • the term "energy window” is intended to encompass what is referred to as a planar-tissue-altering-window/zone in U.S. Patent No. 2185 7,494,488 and, as described later, need not be ultrasonically energized in all embodiments.
  • the "energy window” may comprise a variety of other energy emitting devices, including radiofrequency, intense pulsed light, LASER, thermal, microwave and electrical. It should also be understood that the term “energy window” does not necessarily imply that energy is delivered uniformly throughout the region comprising the energy window. Instead, some energy window implementations may
  • 2190 comprise a series of energy delivering elements or other regions within which energy is delivered with interspersed regions within which no energy, or less energy, is delivered.
  • An ultrasonic energy window configuration may be useful for some implementations, depending upon piezoelectric component and/or energy applied to less aggressively disrupt tissues (in order to possibly increase the concentration of target chemicals and/or biological compounds) at the cellular level to increase the availability of biological and/or
  • Energy window 307 may only be at least substantially planar, or may take on other cross-sectional shapes that may correspond with a portion of the shape of the shaft, such as arced, stair-step, or other geometric shapes/curvatures.
  • Figure 3bb depicts an alternative embodiment of a TD dock 384bb.
  • Figure 3bb depicts an alternative embodiment of a TD dock 384bb.
  • Figure 384bb depicts an alternative embodiment of a TD dock 384bb.
  • the cover may comprise a portion of the shaft and/or tip. More specifically dock 384bb is positioned within a hollow opening formed inside the shaft 302bb and/or tip 301 bb. In an embodiment, the dock may be exposed by separating a portion of the shaft from an adjacent portion off the shaft or an adjacent portion of the tip in a telescoping fashion in order to expose the dock.
  • FIG. 4a An embodiment of a system 400 for performing robotic surgery using a TD is depicted in FIG. 4a.
  • System 400 may comprise a tissue dissecting wand (TD) 401.
  • TD 401 may comprise a tissue dissecting wand (TD) that may, as described elsewhere herein, comprise a plurality of protrusions with one or more recessions positioned therebetween.
  • TD 401 may be coupled with one or more robotic surgery components, such as a surgical arm.
  • Tip 401a may comprise any of the specific embodiments of TD TDM and/or the tips on any such TD/TDM's.
  • TD 401 may comprise a shaft, a tip, and/or a handle, as described elsewhere in this disclosure.
  • TD 401 may be selectively coupled to a robotic arm such that the TD 401 can either be used by hand, or coupled with one or more robotic surgery components to allow a surgeon to perform a surgical procedure with the TD 401 remotely and/or indirectly.
  • the TD may be configured to be integrally coupled with, or otherwise non-selectively coupled with, one or
  • the TD 401 may comprise only a tip.
  • the robotic surgery system 400 may comprise one or more motors, such as a screw-drive motor, gear motor, hydraulic motors, etc.
  • the robotic surgery system 400 may comprise worm gearheads, video cameras, motor control circuits, monitors, remote control
  • TD 400 comprises a TD tip 401a that is positioned at the end of a robotic arm.
  • This robotic arm comprises a plurality of arm segments 473 with corresponding joints 476 positioned therebetween.
  • a primary joint 477 may be positioned to support and articulate together each of the arm segments 473 and smaller joints 476.
  • Primary joint has a primary arm segment 474 that extends therefrom. Finer movements of the robotic arm
  • a stand 481 may also be provided to support the various robotic arms. In some embodiments, stand 481 may also be configured to support a monitor 479 and/or other display, input, or control components, such as a control element 478. In some embodiments, control element 478 may comprise a hand control toggle 478. In other embodiments, control element 478 may comprise a keyboard, mouse, touchscreen display, virtual reality system, control pad, or 2230 the like. Monitor 479 and/or control element 478 may be communicatively coupled with a central processing unit 480.
  • Central processing unit 480 may comprise, for example, one or more microprocessors and/or other electronic components, such as data connectivity elements, memory, non-transitory computer readable media, etc.
  • central processing unit 480 may comprise a general-purpose computer. 2235
  • Central processing unit 480 may further comprise a machine-readable storage device, such as non-volatile memory, static RAM, dynamic RAM, ROM, CD-ROM, disk, tape, magnetic storage, optical storage, flash memory, or another machine-readable storage medium.
  • information from antennae and/or sensors is accessed and/or processed by the central processing unit to guide the robotic arm and/or TD.
  • FIG. 4b illustrates an alternative embodiment of a robotic arm 472 that may be used with system 400.
  • Robotic arm 472 comprises an endoscopic snake-like robotic arm 472 and also comprises a TD 401b positioned at its distal end.
  • TD 401b may be selectively coupled to robotic arm 472 or, alternatively, may be integrally or otherwise non-selectively coupled to robotic arm 472. Further details regarding robotic surgery components that may be useful in connection
  • the geometry of the tip area may comprise protrusions that are not oriented along the axis of the shaft (as seen from a top view); some of these alternative embodiments for tip area geometries are depicted in Figures 5a,b,c,d.
  • TD and/or TDM discussed above including, but not limited to, the embodiments discussed with Figs 1a-L, Figs 2a-L, Figs 3a-L, etc. may be used in conjunction with one or
  • 401 b may comprise any of the specific embodiments of TD/TDM and/or the tips on any such TD/TDM's
  • the tips depicted are contemplated to be able to be used with any of the embodiments discussed herein. Said tips are not intended to be restricted to symmetry and/or pattern and/or dimension. In other embodiments said tips may be asymmetrical or lacking protrusions and/or
  • FIG. 5a is an upper plan view illustrating the protrusions and lysing segments of an embodiment of a tissue dissector, wherein some of the protrusions and lysing segments are oriented in a non-axial direction.
  • This embodiment comprises a plurality of axial protrusions 504a (axially meaning at least substantially parallel to an axis of a corresponding TD shaft).
  • This embodiment further comprises a plurality of non-axial 2270 protrusions 551a along the right side of the tip and a plurality of non-axial protrusions positioned along the left side of the tip.
  • the tip further comprises two non-axial corner protrusions 554a.
  • the tip further comprises a plurality of recessions. One or more of the recessions may further comprise a lysing segment 553a.
  • non-axial protrusions 551a extend in a direction that is at least substantially 2275 perpendicular to the direction in which axial protrusions 504a extend. More particularly, there are two sets of non-axial protrusions 551a (one depicted on the right side and one on the left side of the embodiment of FIG. 5a). Both sets of non-axial protrusions 551a extend in directions that are at least substantially perpendicular to the direction in which axial protrusions 504a extend (namely, along a longitudinal axis of the TD tip). In addition, it can be seen in FIG. 5a that the two sets of non-axial protrusions 551a extend in 2280 directions that are at least substantially opposite from one another.
  • axial protrusions 504a may extend at least substantially along a longitudinal axis of the shaft, as described above, and non-axial protrusions 551a may extend at an angle of between zero degrees and 30 degrees of a normal to the direction in which the axial protrusions 504a extend. It is contemplated that it may desirable for some implementations and embodiments to provide non-axial tips 2285 extending in a direction or directions falling within this range in order to, for example, allow a surgeon to effectively perform both a to and fro, and a side-to-side (“windshield wiper") motion using the TD and/or TDM.
  • windshield wiper side-to-side
  • the tip may measure about 1cm in width and about 1-2 mm in thickness. Sizes of about one-fifth to about five times these dimensions may also have possible uses.
  • the tip can be a separate piece that is secured to the shaft by a variety of methods such as a snap mechanism, mating grooves, plastic sonic welding, etc.
  • the tip can be integral or a continuation of a shaft made of similar metal or materials.
  • the tip may also be constructed of materials that are both electrically non- conductive and of low thermal conductivity; such materials might comprise, for example, porcelain,
  • the tip may be constructed of a support matrix of an insulating material (e.g., ceramic or glass material such as alumina, zirconia).
  • External power control bundles as previously described in other embodiments may connect to electrically conductive elements to bring RF electrosurgical energy from an electrosurgical generator down the shaft to electrically conductive
  • the protrusions may comprise bulbous protrusions.
  • the tip may have between 3 and 100 non-axial protrusions and relative recessions.
  • the tip 501a may alternatively be made partially or completely of concentrically laminated or annealed-in wafer layers of materials that may include plastics, silicon, glass, glass/ceramics, cermets or ceramics. Lysing elements
  • the tip 2305 553a may also be made partially or completely of a cermet material.
  • the tip may be constructed of insulation covered metals or electroconductive materials.
  • the lysing segments may be located at the termini of conductive elements.
  • tip 501a which terminates in protrusions such as 504a and 551a may be made of materials that are both electrically non-conductive and of low thermal conductivity such as
  • the tip may be made from metals or electroconductive materials that are completely or partially insulated.
  • the electrically conductive tissue lysing element(s) 552a may have any geometric shape including a thin cylindrical wire, and may be positioned within the relative recessions of the tip.
  • the electrically conductive lysing element can be in the shape of a plate or plane or wire and made of any metal
  • Optimal materials may include but are not limited to steel, nickel, alloys, palladium, gold, tungsten, silver, copper, and platinum. Metals may become oxidized thus impeding electrical flow and function.
  • FIG. 5b is an upper plan view illustrating the protrusions and lysing segments of another embodiment of a tip area of a tissue dissector.
  • This embodiment may comprise a plurality of axial protrusions 504b and
  • this embodiment comprises two transitional or corner protrusions 554b.
  • a plurality of recessions 552b are also depicted, one or more of which may comprise corresponding lysing segments 553b.
  • FIG. 5c is an upper plan view illustrating the protrusions and lysing segments of an embodiment of a tip area of a tissue dissector. This embodiment comprises a plurality of axial protrusions; this embodiment
  • the 2325 further comprises a plurality of non-axial protrusions 551c along the right side of the tip and a plurality of non-axial protrusions positioned along the left side of the tip.
  • the tip further comprises two non-axial corner protrusions.
  • the tip further comprises a plurality of recessions 552c.
  • One or more of the recessions may further comprise a lysing segment 553c.
  • FIG. 5d is a lower plan view illustrating the protrusions and lysing segments of another embodiment of
  • This embodiment may comprise a plurality of axial protrusions and a plurality of non-axial protrusions 551 d. In addition, this embodiment comprises two transitional or corner protrusions. A plurality of recessions 552d are also depicted, one or more of which may comprise corresponding lysing segments.
  • the tip of FIG. 5d further comprises antenna 518d. In the depicted embodiment, 518d represents an antenna configured to deliver a signal to a receiver unit. In some
  • antenna 518d may comprise any of the antennas described elsewhere herein including for example any of the antennas discussed in connection with antenna 118. (PASTE into TDM)
  • antenna 518d comprises an RFID tag
  • the RFID tag may comprise an RFID transponder.
  • Some embodiments may be further configured such that data from the antenna(s) used in connection 2340 with sensor data from the TD.
  • some embodiments of TDs comprising one or more sensors may be further configured with one or more antenna(s).
  • data from the one or more sensors may be paired or otherwise used in connection with data from the one or more antenna(s).
  • some embodiments may be configured to provide information to a surgeon regarding one or more locations on the body from which one or more sensor readings were obtained.
  • information regarding tissue concentration of a particular protein and/or DNA may be »»»».
  • FIG. 6 is an example of an implementation of a method 600 of use according to this disclosure for the apparatus depicted in Figures 1a-j for tissue/fluid sampling and/or analysis using a sensor may be as follows.
  • a nanosensor capable of detecting a given biochemical and/or biomarker may be sterilely placed in the dock of a sterile TD.
  • the patient may be cleansed and anesthetized and an entrance incision may 2350 be made.
  • Step 605 may comprise inserting the TD into the patient and directing the TD toward the target tissues to be sampled and/or analyzed.
  • Step 610 may comprise activating the antenna/antennae and an accompanying CPU to track the location of the sensor and TD.
  • Step 615 may comprise in some implementations, activating fiberoptics and/or a camera to provide further data, such as visual data, regarding the location of the sensor and TD.
  • Step 620 may comprise once the TD is in a desired location
  • tissue sampling/analysis introducing one or more fluids to facilitate tissue sampling and/or analysis into the space between the cover and dock if desired.
  • Step 625 may comprise exposing the sensor.
  • the sensor may be exposed by opening and/or retracting the cover.
  • the sensor may be exposed by protruding at least a portion of the sensor through openings in the cover, as discussed elsewhere herein.
  • Step 630 may comprise positioning the sensor at a desired location/angle to improve desired contact with target body fluids and/or tissues. In some implementations, this positioning/angling may increase contact between such target fluids/tissues. In some implementations, the sensor(s) may be positioned at a desired location/angle using actuators. Step 635 may comprise agitating and/or vibrating the TD to further improve desired contact between the sensor(s) and the target fluids/tissues. For example, in embodiments
  • vibration means such means may be activated to vibrate the sensor and thereby improve contact and/or tissue sampling.
  • vibration means may be positioned on or adjacent to the handle in order to provide suitable vibration without causing undesirable tissue damage.
  • Step 640 may comprise allowing the sensor(s) to remain in contact with the specimen in the target
  • the senor(s) may be configured to maintain such contact for a predetermined amount of time. In some implementations of method 600 allowing the sensor to remain in contact with the specimen may comprise maintaining such contact for a predetermined amount of time. Step 645 may comprise making the sensor unexposed. In implementations in which the sensor(s) is protruded, step 645 may comprise retracting the sensor back into
  • step 645 may comprise closing the cover.
  • Step 650 may comprise processing the collected biomaterial and/or sensor data. If further processing of the collected material and/or sensor data is necessary while the TD is still at the target zone then such processing may take place within the dock after sampling. In some implementations, one or more external fluids and/or reagents may be delivered into the dock to facilitate chemical reactions and/or interactions.
  • Step 655 may comprise cleaning the sensor, such as cleaning for re-use at the next target site.
  • one or more fluids such as cleaning agents (or just water) may be introduced in the dock to facilitate such cleaning.
  • Such fluids may also be extracted from the dock using vacuum ports, as described elsewhere herein, if needed.
  • Step 660 may comprise readying a sensor for another procedure.
  • step 660 may comprise regenerating the existing sensor.
  • step 660 may comprise exposing a new sensor. Once the sensor has been regenerated or a new sensor has been exposed, the TD/TDM may be moved and/or tracked to the next target site by the surgeon and the process repeated for additional sampling/analysis.
  • FIG. 2390 One implementation of a method 700 according to this disclosure for accessing an organ with the assistance of a TD is shown in Figure 7.
  • surgeon(s) may need to access tissue and/or an organ to repair or treat it.
  • the skin surrounding the anticipated entrance wound for the surgical area may be cleansed by, for example, with isopropyl alcohol (degreaser) followed by germicidal chlorhexidine scrub.
  • a local anesthetic may be applied (such as by injecting) 1 % 2395 lidocaine + 1 :10,000adrenaline to the skin.
  • Step 705 may comprise, for minimally invasive procedures or minimally invasive entrance wounds, performing a limited incision to allow passage of the maximal width of the tip or shaft of the TD.
  • Step 705 may be performed with, for example, a #15 Bard-ParkerTM Scalpel. This incision may be deepened by scalpel, scissors or other surgical instrument to enter the desired body structure or cavity. For larger,
  • step 705 may comprise the initial skin opening or body cavity opening steps of such a procedure.
  • step 710 may comprise making the skin incision using the lysing segments of the TD.
  • Step 710 may comprise: applying one or more fluids to the tissues.
  • step 710 may comprise applying fluids to the target tissue(s).
  • step 710 may comprise applying fluids to the tissues to be
  • the fluid(s) may comprise water.
  • the fluid(s) may comprise an ionic fluid, such as a saline solution.
  • the fluid(s) may be applied to the tissue via, for example, injection, or TD fluid port or via a separate cannula or catheter or via pouring or via spray.
  • the fluid(s) may comprise an ionic fluid and an anesthetic, such as a tumescent
  • step 710 may comprise applying one or more fluids that serve as an ionic fluid, and/or an anesthetic, and/or adrenaline.
  • the fluid(s) may comprise a Klein Formula.
  • the Klein formula and amount used may be about 100cc of Klein Formula with saline, 0.1% lidocaine,
  • Step 715 may comprise: passing the TD through the various layers of tissue to create a path to a target organ.
  • creating a path to a target organ or other target tissue may comprise creating a path from the incision to the target organ or other target tissue and/or creating a path around the target organ or other target tissue to allow for access to other regions of the target organ or other target
  • step 715 may further comprise activating the lysing segments and/or energy window to reduce bleeding or tissues traversed on the way to the target organ.
  • the lysing segments and/or energy window may be used to induce fibrosis along the path, including along a path that may traverse the perimeter of the target organ/tissue.
  • the TD and/or the anticipated path may be visualized using for example an endoscope, a
  • an antenna(s)or other such device may be positioned on the TD.
  • a device or devices may be separate from the TD.
  • heat may be produced or energy may otherwise be released in the tissues through which the TD is passed.
  • heating portions of the tissues the TD passes by may be undesirable. As such, in some implementations, undesirable heating of such layers may
  • Such steps may comprise use of one or more cooling fluids delivered via the TD or one or more separate catheters or cannulas or endoscopes.
  • Such cooling mechanism(s) may comprise for example, a closed water bag.
  • a bag may be at a temperature of less than 37°C.
  • cooling objects such as fluid or gel filled bags may be used that may range in temperature between about 1 °C to
  • Step 720 may comprise identifying important blood vessels, nerves, ducts, organs or other anatomy in the area surrounding the target tissue.
  • Step 725 may comprise: adding additional fluids of the types previously described to the target and/or surrounding tissues via the TD port(s)
  • Step 730 may comprise: expanding one or more regions of the path to the target tissue. In some implementations, step 730 may comprise expanding one or more path(s) from the incision to the target tissue. In some implementations, step 730 may comprise expanding a region around the target tissue such as for example, via a fanning motion. In some implementations, one or more of the other steps described herein using the TD may also be
  • step 730 may further comprise activating the energy
  • Step 735 may comprise: observing for bleeding from larger vessels and achieving hemostasis as needed.
  • achieving hemostasis may be accomplished by cautery, electrifying, ligating, or chemical methods.
  • the lysing segment and/or the energy window can be used to achieve the hemostasis.
  • Step 740 may comprise: removing the TD with power off and suturing the wound in the standard fashion.
  • the tissues traversed may require closure by suturing and/or stapling.
  • organs and/or organ systems that the TD may be useful to access may include but not limited to muscle, and/or parotid, and/or salivary gland, and/or thyroid, and/or lung, and/or heart, and/or gastrointestinal, and/or liver, and/or
  • FIG. 8 depicts a flow chart of an implementation of a method 800 for sampling and/or testing tissue using a TD.
  • the use of combined data from the tissue dissecting wand generated from at least the sensor and the antenna(s) may be used to provide suitable feedback to a user
  • the TD Wand may comprise a tip comprising a plurality of protrusions.
  • One or more lysing segments may be positioned between at least two adjacent protrusions among the plurality of protrusions.
  • a sensor such as a nanosensor, may be positioned on the TD. The sensor may be configured to sense a concentration of a chemical and/or biological compound contained in at least one of tissue and fluid adjacent to the tissue dissecting wand during an operation.
  • the TD 2470 which a concentration of a chemical and/or biological compound reading is taken may comprise, for example, fluid from adjacent tissue(s) and/or fluid introduced during the procedure by way of the TD and/or another device or procedure.
  • the TD may also comprise an antenna(s) such as an RFID tag positioned on the TD.
  • the antenna(s) may be positioned on the tip and/or distal end of the shaft, such as on a bottom surface of the tip and/or distal end of the shaft.
  • the antenna(s) may be
  • method 800 configured to provide location data regarding a location of the TD, such as a particular portion or region of the TD for example, during an operation or procedure.
  • a location of the TD such as a particular portion or region of the TD for example, during an operation or procedure.
  • method 800 is shown in the figure beginning with step 805, it should be understood that any of the preliminary steps described above in connection with other implementations may be performed in method 800 as well. For example, one or more of steps (705-730) from method 700 may be performed in method 800 if desired. Similarly, one or
  • step 805 may comprise: receiving data from the tissue dissecting wand sensor.
  • Step 810 may comprise receiving data from the antenna(s) such as RFID tag data.
  • Step 815 may comprise combining the data generated from at least the sensor and the antenna(s). In some implementations, the data from the sensor and the antenna(s) may be combined before it is
  • a step of "receiving combined data from the tissue dissecting wand generated from at least the sensor and the antenna(s) may comprise receiving precombined data (data from the sensor and the antenna(s) that was combined before it was received) or, alternatively, may comprise separately receiving sensor data and antenna(s) data that may be combined to allow for one or more particular features or functionalities.
  • the combined data may be used to allow a surgeon or other user to
  • the combined data may allow a user to visualize one or more regions within a patient's body, such as one or more regions that have been sufficiently treated. This may be accomplished, for example, by creating an image corresponding with one or more regions of a patient's body. Such image or images may be highlighted, receive color changes, or
  • regions 2495 otherwise modified on a display may indicate to the user which regions have been adequately tested and or sampled.
  • regions may correspond with regions comprising tissue that has reached a predetermined threshold chemical and/or biological compound and/or biomarker concentration.
  • Some embodiments may be configured with a detector and/or optical scanner configured to detect reflected light from a particular organ or tissue. For example, some embodiments may be configured to
  • Some such embodiments may comprise, for example, a polarized multispectral light scattering/scanning system, such as are disclosed in U.S. Patent Application Publication No. 2012/0041290 titled "Endoscopic Polarized Multispectral Light Scattering Scanning Method," which is hereby incorporated by reference in its entirety.
  • data from the detector/scanner may be coupled with data from one or more other devices/components, such as an RFID tag or another antenna, to provide addition detail/information to a surgeon during a procedure with the TD/TDM.
  • data from the reflected radiation source may be used to identify an organ adjacent to the TD/TDM. This data may be combined with location data from the
  • a surgeon might be provided with visual and/or audible information indicating that the TD/TDM is approaching or being withdrawn from the liver.
  • the surgeon may be provided with additional detail, such as the current distance to the organ, directions for reaching the organ without causing undue harm to
  • one or more of the sensors 110, 114, 210, 214, 310, and/or 314 may comprise such a detector/scanner.
  • some of the processing of reflected radiation may be done on the TD/TDM.
  • the TD TDM may simply comprise one or more fiber optic elements, as discussed elsewhere herein, which may be configured to receive the reflected radiation and transfer it outside of the body to another system,
  • the one or more fiber optic elements may also be configured to emit the radiation to be reflected.
  • additional fiber optic elements and/or other radiation-emitting elements may be provided for this purpose.
  • electromagnetic delivery element(s) 115 and/or sensors 110, 114, 210, 214, 310, and/or 314 may be found in Laser Reflectance Imaging of Human Chest for Localization of Internal Organs (Contact Fiber Probes For In-Vivo Optical Spectroscopy (Kumaravel, Singh; Biomedical Engineering, IEEE, 2010, 57(5) 1167-1175.) which is hereby incorporated by reference in its entirety.
  • TD/TDM may be inserted within a patient's body at 905.
  • a radiation source may be activated to emit light or another form of electromagnetic radiation to be used in detecting an organ or tissue.
  • step 910 may further comprise directing the radiation towards an organ or tissue to be identified.
  • reflected light from the radiation source may be received and analyzed. As discussed above, in some implementations, such analysis may comprise a spectral analysis, such as using
  • step 920 location data, such as from an antenna, may be received. In some implementations, such location data may be combined with data obtained from analysis of the reflected radiation. Thus, at step 925, information may be provided to a user that may comprise location data and organ/tissue identification data. For example, as discussed above, in some implementations step 925 may comprise providing information to a surgeon regarding what
  • FIG. 10 depicts an embodiment of a modular TD 1000 comprising a tip 1001 , a flexible shaft 1002, and an endoscope handle 1003.
  • Tip 1001 is modular in that it is removable from flexible shaft 1002. More particularly, tip 1001 comprises a means for removably coupling the tip with a shaft at 1068. In the depicted embodiment, this coupling means comprises a tip plug 1068. In some embodiments, tip plug
  • the coupling means may comprise a recess configured to receive a plug formed on the shaft.
  • the coupling means may comprise a snap-fit coupling, a friction fit coupling, a bayonet clip, etc.
  • tip plug 1068 is configured to be received within a corresponding recess
  • tip plug 1068 may be configured to electrically couple tip 1001 with shaft 1002. In this manner, in embodiments comprising, for example, lysing segments, electricity from a power source may be transmitted through the coupling between plug 1068 and recess 1069 to allow for energizing the lysing segments. Other embodiments may be configured to transfer additional electricity, data, or materials through such coupling. For example, in embodiments comprising
  • a signal from such sensor(s) may be transmitted through shaft 1002 by way of the coupling means 1068.
  • tip 1001 may be disposable as well, such that a surgeon can place an appropriate tip on the shaft and remove and dispose of the tip after surgery.
  • a plurality of different tips may be provided, each of which may be disposable, or may be configured for
  • tip 1001 comprises a plurality of protrusions 1004, some of which are non-axial, and a plurality of recessions 1005 positioned therebetween, as described above.
  • a tip comprising only axial protrusions may be swapped for tip 1001 as desired to suit a particular surgical procedure.
  • FIG. 11 depicts an alternative embodiment of a TD 1100 comprising a tip 1101 and an endoscope handle 1103.
  • TD 1100 comprises a shaft comprising a rigid segment 1102a and a flexible segment 1102b.
  • FIG. 11 further comprises a biosensor dock 1184.
  • dock 1184 is positioned along rigid segment 1102a of shaft 1102.
  • Dock 1184 also comprises a cover 1180 that is selectively movable via means for selectively moving a cover 1183 which may be positioned
  • cover moving means may include rails, grooves, tracks, ratchets, cables, arms, lines, etc.
  • the cover moving means comprises a rail.
  • a portion of the shaft may comprise cover moving means 1183. It is contemplated that in alternative embodiments, cover moving means 1183 may be omitted.
  • Cover 1180 comprises a rear end 1182 and a pointed front end 1181.
  • Rigid segment 1102a further comprises a second energy window
  • an energy window such as first energy window 1107
  • Biosensor dock 1184 may further comprise any of the features and components of any of the other docks described in connection with other embodiments presented herein, including fluid delivery ports, fluid extraction ports, sensors, seats, heaters, mixing elements, etc.
  • first energy window 1107 and/or second energy window 1108 may be omitted.
  • the embodiment of FIG. 11 may comprise a modular and/or disposable tip 1101 , such that a surgeon can place an appropriate tip on the shaft and remove and dispose of the tip after surgery.
  • a plurality of different tips may be provided, each of which may be disposable, or may be configured for sterilization and re-use, and an appropriate tip may be selected as needed for a particular surgery.
  • tip 1101 may be removably attached to rigid shaft
  • any reference to "one embodiment,” “an embodiment,” or “the embodiment” means that a particular feature, structure, or characteristic described in connection with that
  • 2595 embodiment is included in at least one embodiment.
  • the quoted phrases, or variations thereof, as recited throughout this specification are not necessarily all referring to the same embodiment.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Biophysics (AREA)
  • Optics & Photonics (AREA)
  • Hematology (AREA)
  • Apparatus Associated With Microorganisms And Enzymes (AREA)
  • Surgical Instruments (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

Procédés, appareil et systèmes destinés à la dissection et au test de tissus. Un procédé de dissection et de test de tissus peut consister à introduire une baguette de dissection de tissus (TD) dans une incision faite dans le corps d'un patient. La TD peut comprendre une pointe présentant une pluralité de saillies dotées de segments de lyse positionnés entre les saillies pour disséquer et/ou modifier les tissus. La TD peut également comprendre une plage pour capteur positionnée sur la TD qui est configurée pour permettre aux tissus et/ou aux fluides corporels d'entrer en contact avec un capteur. Après la séparation des tissus à l'aide du(des) segment(s) de lyse pour accéder à une région cible, le capteur peut être activé et déplacé dans la région cible afin d'accéder aux tissus.
PCT/NZ2014/000015 2013-02-14 2014-02-14 Systèmes, appareil et procédés pour dissection de tissus WO2014126482A2 (fr)

Priority Applications (5)

Application Number Priority Date Filing Date Title
AU2014216758A AU2014216758A1 (en) 2013-02-14 2014-02-14 Systems, apparatus and methods for tissue dissection
EP14752036.5A EP2956066A4 (fr) 2013-02-14 2014-02-14 Systèmes, appareil et procédés pour dissection de tissus
CN201480017956.0A CN105188561B (zh) 2013-02-14 2014-02-14 生物组织剖割的系统、装置和方法
GB1514773.9A GB2525800A (en) 2013-02-14 2014-02-14 Systems, apparatus and methods for tissue dissection
BR112015019449A BR112015019449A2 (pt) 2013-02-14 2014-02-14 sistemas, aparelhos e métodos para a dissecção de tecidos

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13/767,876 US10045761B2 (en) 2012-12-31 2013-02-14 Systems, apparatus and methods for tissue dissection
US13/767,876 2013-02-14

Publications (2)

Publication Number Publication Date
WO2014126482A2 true WO2014126482A2 (fr) 2014-08-21
WO2014126482A3 WO2014126482A3 (fr) 2014-10-16

Family

ID=51354646

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/NZ2014/000015 WO2014126482A2 (fr) 2013-02-14 2014-02-14 Systèmes, appareil et procédés pour dissection de tissus

Country Status (6)

Country Link
EP (1) EP2956066A4 (fr)
CN (1) CN105188561B (fr)
AU (1) AU2014216758A1 (fr)
BR (1) BR112015019449A2 (fr)
GB (1) GB2525800A (fr)
WO (1) WO2014126482A2 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108366789A (zh) * 2015-12-11 2018-08-03 英国质谱公司 反馈装置
WO2020146045A1 (fr) * 2019-01-11 2020-07-16 University Of Cincinnati Extraction et détection continues de fluide interstitiel
US20210069695A1 (en) * 2019-09-06 2021-03-11 The Regents Of The University Of California Cloud-enabled passive wireless ionic sensing in small vials
US11284817B2 (en) 2016-10-25 2022-03-29 Roche Diabetes Care, Inc. Method for determination of an analyte concentration in a body fluid and analyte concentration measurement device

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107102028B (zh) * 2016-02-23 2019-09-17 王玉麟 组织辨识方法以及用于组织辨识的生物传感器
CN105997068A (zh) * 2016-06-15 2016-10-12 苏州海神联合医疗器械有限公司 一种微阵列肌电表面电极
CN111465355B (zh) * 2017-09-25 2023-06-09 保罗·韦伯 组织微创解剖设备和系统
CN110711014B (zh) * 2019-10-21 2021-04-13 南通大学 一种切口边缘皮肤切除器

Citations (32)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4221997A (en) 1978-12-18 1980-09-09 Western Electric Company, Incorporated Articulated robot arm and method of moving same
US4259876A (en) 1979-10-02 1981-04-07 Belyanin Petr N Mechanical arm
US4462748A (en) 1981-07-04 1984-07-31 Fujitsu Fanuc Ltd. Industrial robot
US4494417A (en) 1979-03-16 1985-01-22 Robotgruppen Hb Flexible arm, particularly a robot arm
US4631689A (en) 1983-03-26 1986-12-23 Tokyo Shibaura Denki Kabushiki Kaisha Multi-joint arm robot apparatus
US4806066A (en) 1982-11-01 1989-02-21 Microbot, Inc. Robotic arm
US5607607A (en) 1993-11-01 1997-03-04 Naiman; Charles S. System and assemblage for producing microtexturized substratesand implants
US5791231A (en) 1993-05-17 1998-08-11 Endorobotics Corporation Surgical robotic system and hydraulic actuator therefor
US6593093B1 (en) 2002-02-20 2003-07-15 Mayo Foundation For Medical Education And Research Detection of group a Streptococcus
US6716620B2 (en) 2000-04-17 2004-04-06 Purdue Research Foundation Biosensor and related method
US6870235B2 (en) 2002-05-15 2005-03-22 Fujitsu Limited Silicon-on-insulator biosensor device
US20060223080A1 (en) 2004-11-09 2006-10-05 Gen-Probe Incorporated Compositions and methods for detecting group a streptococci
US7129554B2 (en) 2000-12-11 2006-10-31 President & Fellows Of Harvard College Nanosensors
US7199545B2 (en) 2003-07-08 2007-04-03 Board Of Regents Of The University Of Nebraska Robot for surgical applications
US20070225550A1 (en) 2006-03-24 2007-09-27 Abhishek Gattani System and method for 3-D tracking of surgical instrument in relation to patient body
US7294526B2 (en) 2002-12-17 2007-11-13 Hewlett-Packard Development Company, L.P. Nano optical sensors via molecular self-assembly
US7316681B2 (en) 1996-05-20 2008-01-08 Intuitive Surgical, Inc Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US7416911B2 (en) 2003-06-24 2008-08-26 California Institute Of Technology Electrochemical method for attaching molecular and biomolecular structures to semiconductor microstructures and nanostructures
US7494488B2 (en) 1998-05-28 2009-02-24 Pearl Technology Holdings, Llc Facial tissue strengthening and tightening device and methods
US20090140167A1 (en) 2005-09-06 2009-06-04 Natero, Inc. Nanotube fabric-based sensor systems and methods of making same
US20090186774A1 (en) 2006-05-20 2009-07-23 Carrie Jane Turner Sepsis detection microarray
US20090281419A1 (en) 2006-06-22 2009-11-12 Volker Troesken System for determining the position of a medical instrument
US7674389B2 (en) 2004-10-26 2010-03-09 The Regents Of The University Of California Precision shape modification of nanodevices with a low-energy electron beam
US20100280409A1 (en) 2008-09-30 2010-11-04 Mark Joseph L Real-time pathology
US7993538B2 (en) 2004-12-09 2011-08-09 President And Fellows Of Harvard College Patterning by energetically-stimulated local removal of solid-condensed-gas layers and solid state chemical reactions produced with such layers
US20120041290A1 (en) 2009-01-23 2012-02-16 Beth Israel Deaconess Medical Center, Inc Endoscopic polarized multispectral light scattering scanning method
US8182418B2 (en) 2008-02-25 2012-05-22 Intuitive Surgical Operations, Inc. Systems and methods for articulating an elongate body
US8224485B2 (en) 2006-05-24 2012-07-17 Titan Medical Inc. Snaking robotic arm with movable shapers
US8236595B2 (en) 2006-08-11 2012-08-07 Agency For Science, Technology And Research Nanowire sensor, nanowire sensor array and method of fabricating the same
US20120228155A1 (en) 2009-09-30 2012-09-13 Virogenomics, Inc. Electromagnetic detection of analytes
EP2526427A2 (fr) 2010-01-19 2012-11-28 President and Fellows of Harvard College Dispositif et procédé de diagnostic pathogène rapide
US20120304776A1 (en) 2010-08-15 2012-12-06 Vlad Joseph Novotny Chemical and Biomedical NanoSensors

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6699186B1 (en) * 2000-03-10 2004-03-02 Remon Medical Technologies Ltd Methods and apparatus for deploying and implantable biosensor
US6558382B2 (en) * 2000-04-27 2003-05-06 Medtronic, Inc. Suction stabilized epicardial ablation devices
US20050131390A1 (en) * 2002-04-25 2005-06-16 Russell Heinrich Surgical instruments including mems devices
US7566318B2 (en) * 2003-04-11 2009-07-28 Cardiac Pacemakers, Inc. Ultrasonic subcutaneous dissection tool incorporating fluid delivery
US8306592B2 (en) * 2003-12-19 2012-11-06 Olympus Corporation Capsule medical device
WO2006113394A2 (fr) * 2005-04-15 2006-10-26 Surgisense Corporation Instruments chirurgicaux dotes de capteurs destines a detecter des proprietes tissulaires et systemes utilisant ces instruments
US20090012519A1 (en) * 2007-07-03 2009-01-08 Lisette Manrique Electro-Surgical Bipolar Forceps

Patent Citations (34)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4221997A (en) 1978-12-18 1980-09-09 Western Electric Company, Incorporated Articulated robot arm and method of moving same
US4494417A (en) 1979-03-16 1985-01-22 Robotgruppen Hb Flexible arm, particularly a robot arm
US4259876A (en) 1979-10-02 1981-04-07 Belyanin Petr N Mechanical arm
US4462748A (en) 1981-07-04 1984-07-31 Fujitsu Fanuc Ltd. Industrial robot
US4806066A (en) 1982-11-01 1989-02-21 Microbot, Inc. Robotic arm
US4631689A (en) 1983-03-26 1986-12-23 Tokyo Shibaura Denki Kabushiki Kaisha Multi-joint arm robot apparatus
US5791231A (en) 1993-05-17 1998-08-11 Endorobotics Corporation Surgical robotic system and hydraulic actuator therefor
US5645740A (en) 1993-11-01 1997-07-08 Naiman; Charles S. System and assemblage for producing microtexturized substrates and implants
US5607607A (en) 1993-11-01 1997-03-04 Naiman; Charles S. System and assemblage for producing microtexturized substratesand implants
US7316681B2 (en) 1996-05-20 2008-01-08 Intuitive Surgical, Inc Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US20110144729A1 (en) 1998-05-28 2011-06-16 Paul Joseph Weber Facial tissue strengthening and tightening device and methods
US7494488B2 (en) 1998-05-28 2009-02-24 Pearl Technology Holdings, Llc Facial tissue strengthening and tightening device and methods
US6716620B2 (en) 2000-04-17 2004-04-06 Purdue Research Foundation Biosensor and related method
US7129554B2 (en) 2000-12-11 2006-10-31 President & Fellows Of Harvard College Nanosensors
US6593093B1 (en) 2002-02-20 2003-07-15 Mayo Foundation For Medical Education And Research Detection of group a Streptococcus
US6870235B2 (en) 2002-05-15 2005-03-22 Fujitsu Limited Silicon-on-insulator biosensor device
US7294526B2 (en) 2002-12-17 2007-11-13 Hewlett-Packard Development Company, L.P. Nano optical sensors via molecular self-assembly
US7416911B2 (en) 2003-06-24 2008-08-26 California Institute Of Technology Electrochemical method for attaching molecular and biomolecular structures to semiconductor microstructures and nanostructures
US7199545B2 (en) 2003-07-08 2007-04-03 Board Of Regents Of The University Of Nebraska Robot for surgical applications
US7674389B2 (en) 2004-10-26 2010-03-09 The Regents Of The University Of California Precision shape modification of nanodevices with a low-energy electron beam
US20060223080A1 (en) 2004-11-09 2006-10-05 Gen-Probe Incorporated Compositions and methods for detecting group a streptococci
US7993538B2 (en) 2004-12-09 2011-08-09 President And Fellows Of Harvard College Patterning by energetically-stimulated local removal of solid-condensed-gas layers and solid state chemical reactions produced with such layers
US20090140167A1 (en) 2005-09-06 2009-06-04 Natero, Inc. Nanotube fabric-based sensor systems and methods of making same
US20070225550A1 (en) 2006-03-24 2007-09-27 Abhishek Gattani System and method for 3-D tracking of surgical instrument in relation to patient body
US20090186774A1 (en) 2006-05-20 2009-07-23 Carrie Jane Turner Sepsis detection microarray
US8224485B2 (en) 2006-05-24 2012-07-17 Titan Medical Inc. Snaking robotic arm with movable shapers
US20090281419A1 (en) 2006-06-22 2009-11-12 Volker Troesken System for determining the position of a medical instrument
US8236595B2 (en) 2006-08-11 2012-08-07 Agency For Science, Technology And Research Nanowire sensor, nanowire sensor array and method of fabricating the same
US8182418B2 (en) 2008-02-25 2012-05-22 Intuitive Surgical Operations, Inc. Systems and methods for articulating an elongate body
US20100280409A1 (en) 2008-09-30 2010-11-04 Mark Joseph L Real-time pathology
US20120041290A1 (en) 2009-01-23 2012-02-16 Beth Israel Deaconess Medical Center, Inc Endoscopic polarized multispectral light scattering scanning method
US20120228155A1 (en) 2009-09-30 2012-09-13 Virogenomics, Inc. Electromagnetic detection of analytes
EP2526427A2 (fr) 2010-01-19 2012-11-28 President and Fellows of Harvard College Dispositif et procédé de diagnostic pathogène rapide
US20120304776A1 (en) 2010-08-15 2012-12-06 Vlad Joseph Novotny Chemical and Biomedical NanoSensors

Non-Patent Citations (43)

* Cited by examiner, † Cited by third party
Title
"Direct Ultrasensitive Electrical Detection of DNA and DNA Sequence Variations Using Nanowire Nanosensors", NANO LETTERS, vol. 4, no. 1, 2003, pages 51 - 54
BOROLE, DD ET AL., DES MONOMERS POLYMERS, vol. 9, no. 1, 2006, pages 1 - 11
CIU, WANG, HUYNH, LIEBER, ULTRASENSITIVE AND SELECTIVE MULTIPLEXING DETECTION OF CANCER MARKERS USING NANOWIRE NANOSENSORS, pages 1 - 21
CIU; WANG; HUYNH; LIEBER, ULTRASENSITIVE AND SELECTIVE MULTIPLEXING DETECTION OF CANCER MARKERS USING NANOWIRE NANOSENSORS, pages 1 - 21
DIEDERICH, BURDETTE, IEEE TRANS ULTRASON FERROELECTR FREQ CONTROL, vol. 43, no. 6, 1996, pages 1011 - 1022
HINE, CHEN, BIOCHEM. SOC.TRANS, vol. 37, 2009, pages 445 - 449
JAROSZ, IEEE TRANS BIOMED ENG, vol. 43, no. 11, 1996, pages 1106 - 1115
KINSEY, DIEDERICH, TYREUS ET AL., MED PHYS, vol. 33, no. 5, 2006, pages 1352 - 1363
KULKARNI ET AL., J BIOTECHNOL, vol. 160, no. 3-4, 31 August 2012 (2012-08-31), pages 91 - 96
KUMARAVEL, SINGH: "Contact Fiber Probes For In-Vivo Optical Spectroscopy", BIOMEDICAL ENGINEERING, IEEE, vol. 57, no. 5, 2010, pages 1167 - 1175
LEE ET AL., ULTRASOUND MED BIOL, vol. 31, 2005, pages 971 - 977
LEE, KIM, ZHENG, NANO LETT, vol. 11, no. 8, 2011, pages 3435 - 3439
LI ET AL.: "Sequence-Specific Label-Free DNA Sensors Based on Silicon Nanowires", NANO LETTERS, vol. 4, no. 2, 2004, pages 245 - 247, XP002407747, DOI: doi:10.1021/nl034958e
MAILLEY, LIVACHE: "Electrochemistry of Nucleic Acids and Proteins", TOWARDS ELECTROCHEMICAL SENSORS FOR GENOMICS AND PROTEOMICS, 2005, pages 297 - 330
MOHANTY ET AL, FIELD EFFECT TRANSISTOR NANOSENSOR FOR BREAST CANCER DIAGNOSTICS, pages 1 - 25
MOHANTY; CHEN; WANG; HONG; ROSENBERG; WEAVER; ERRAMILLI, FIELD EFFECT TRANSISTOR NANOSENSORFOR BREAST CANCER DIAGNOSTICS, pages 1 - 25
MONRO, WARREN-SMITH, OPT FIBER TECHNOL, vol. 16, no. 6, 2010, pages 343 - 356
NAU, DIEDERICH, BURDETTE, MED PHYS, vol. 28, no. 7, 2001, pages 1525 - 1534
PENG ET AL.: "Novel Conducting Polymers for DNA Sensing", MACROMOLECULES, vol. 40, no. 4, 2007, pages 909 - 914
PENG, H. ET AL., BIOMATERIALS, vol. 30, no. 11, 2009, pages 2132 - 2148
PETER ET AL., FRESENIUS' JOURNAL OF ANALYTICAL CHEMISTRY, vol. 371, no. 2, 2001, pages 120 - 127
RUAN, FOO, OPT. EXPRESS, vol. 16, no. 22, 2008, pages 18514 - 18523
SCHOELHAMMER ET AL., JOURNAL OF CONTROLLED RELEASE, vol. 163, no. 2, 2012, pages 154 - 160
See also references of EP2956066A4
SHU-YAN NIU ET.AL., J FLOURESC, vol. 18, 2008, pages 227 - 235
SMITH, OPTICS EXPRESS, vol. 20, no. 28, 31 December 2012 (2012-12-31)
STROHSAHL, MILLER, KRAUSS, PROC. OF SPIE, vol. 71670S, pages 1 - 12
STROHSAHL, MILLER, KRAUSS: "Detection of Methicillin-Resistant Staphylococcus aureus (MRSA) using the NanoLantern Biosensor", PROC. OF SPIE, vol. 71670S, pages 1 - 12
STROHSAHL; MILLER; KRAUSS: "Detection of Methicillin-Resistant Staphylococcus aureus (MRSA) using the NanoLantern Biosensor", PROC. OF SPIE, vol. 71670S, pages 1 - 12
TANG, BANKSCHTEIN, LANGER, J PHARM SCI., vol. 91, 2002, pages 1776 - 1794
TATON, MIRKIN, LESTINGER: "Scanometric DNA Array Detection with Nanoparticle Probes", SCIENCE, vol. 289, no. 5485, 8 September 2000 (2000-09-08), pages 1757 - 1760, XP002294468, DOI: doi:10.1126/science.289.5485.1757
TATON; MIRKIN; LESTINGER: "Scanometric DNA Array Detection with Nanoparticle Probes", SCIENCE, vol. 289, no. 5485, 8 September 2000 (2000-09-08), pages 1757 - 1760, XP002294468, DOI: doi:10.1126/science.289.5485.1757
VROLIJK ET AL., CYTOMETRY, vol. 15, no. 1, 1994, pages 2 - 11
WALLACE, SPINKS, TEESDALE, vol. 317, 1998, pages 287 - 290
WALLACE, SPINKS; KANE-MAGUIRE: "Conductive Electroactive Polymers: Intelligent Materials Systems", 2002, pages: 224
WALT, CHEM. SOC. REV, vol. 39, no. 1, 2009, pages 38 - 50
WANEKAYA ET AL.: "Handbook of Biosensors and Biochips", 2007, pages: 831 - 842
WANG, COOPER, WANG, J. LIGHTWAVE TECHNOL, vol. 26, no. 17, 2008, pages 3181 - 3185
WEISSE, KIM, LEE, ZHENG, NANO LETT, vol. 11, no. 3, 2011, pages 1300 - 1305
YANG, KIM, YUN, ARCH PHARM RES., vol. 29, 2006, pages 412 - 417
YI CUI ET AL.: "Nanowire Nanosensors for Highly Sensitive and Selective Detection of Biological and Chemical Species", SCIENCE, vol. 293, 2001, pages 1289, XP002264236, DOI: doi:10.1126/science.1062711
YU, ZHANG, WANG, SHUM, SIMTECH, 2010, pages 42 - 45
ZHANG ET AL.: "Sensing by Silicon Nanowire: Charge Layer Distance Dependence", NANO LETTERS, vol. 8, no. 4, 2008, pages 1066 - 1070

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108366789A (zh) * 2015-12-11 2018-08-03 英国质谱公司 反馈装置
US11284817B2 (en) 2016-10-25 2022-03-29 Roche Diabetes Care, Inc. Method for determination of an analyte concentration in a body fluid and analyte concentration measurement device
WO2020146045A1 (fr) * 2019-01-11 2020-07-16 University Of Cincinnati Extraction et détection continues de fluide interstitiel
US20210069695A1 (en) * 2019-09-06 2021-03-11 The Regents Of The University Of California Cloud-enabled passive wireless ionic sensing in small vials
US11529632B2 (en) * 2019-09-06 2022-12-20 The Regents Of The University Of California Cloud-enabled passive wireless ionic sensing in small vials

Also Published As

Publication number Publication date
GB201514773D0 (en) 2015-09-30
BR112015019449A2 (pt) 2018-02-06
EP2956066A4 (fr) 2016-10-19
CN105188561B (zh) 2019-04-05
GB2525800A (en) 2015-11-04
AU2014216758A1 (en) 2015-08-27
CN105188561A (zh) 2015-12-23
EP2956066A2 (fr) 2015-12-23
WO2014126482A3 (fr) 2014-10-16

Similar Documents

Publication Publication Date Title
US10045761B2 (en) Systems, apparatus and methods for tissue dissection
WO2014126482A2 (fr) Systèmes, appareil et procédés pour dissection de tissus
US8968302B2 (en) Methods, apparatus, and systems for tissue dissection and modification
US10842566B1 (en) Biophotonic surgical probe
US20210137410A1 (en) Intelligent surgical probe for real-time monitoring of electroporation-based therapies
WO2007020680A1 (fr) Accessoire endoscopique, systeme de traitement analytique de tissus biologiques et procede d'echantillonnage destine au traitement analytique de tissus
US20140188095A1 (en) Apparatus and systems for tissue dissection and modification
US20100081928A1 (en) Histological Facilitation systems and methods
US8609041B2 (en) Apparatus for solubilizing tissue
US20150359585A1 (en) Apparatus, systems, and methods for dissection and modification of tissues
EP3013271B1 (fr) Appareil de dissection et de modification de tissus
US20190216445A1 (en) Instrumented biopsy probe
CN103237492A (zh) 应用于生物医学中的微型器件及其用法
EP2326253A2 (fr) Sonde d échantillonnage chirurgicale intégrée
JP6108501B2 (ja) マイクロ波照射器具
US20160367311A1 (en) Instrumentation with Embedded Imaging Systems
US20100081915A1 (en) Histological facilitation systems and methods
JP6470173B2 (ja) 組織性状診断及び治療で用いる医療装置
KR20210041563A (ko) 기구 연결을 위한 시스템 및 방법
CN206630667U (zh) 携带感应探头的工作镜
Su et al. Multi-functional Neurosurgical Tool with CCD-Imaging, Suction and Electrical Coagulation
WO2014064607A1 (fr) Appareil et systèmes pour dissection et modification de tissus
US20240197165A1 (en) Method of and system for obesity treatment using laparoscopically-guided 3d-stereoscopic and ir-thermographic intra-abdominal visceral fat aspiration, supported by real-time cytokine sensing and profiling and augmented-reality (ar) display and visual sample tagging
DeLorey et al. A c able‐driven soft robotic end‐effector actuator for probe‐based confocal laser endomicroscopy: Development and preclinical validation
WO2010018536A2 (fr) Dispositif de biopsie à main guidé par imagerie

Legal Events

Date Code Title Description
WWE Wipo information: entry into national phase

Ref document number: 201480017956.0

Country of ref document: CN

ENP Entry into the national phase

Ref document number: 1514773

Country of ref document: GB

Kind code of ref document: A

Free format text: PCT FILING DATE = 20140214

WWE Wipo information: entry into national phase

Ref document number: 1514773.9

Country of ref document: GB

Ref document number: 2014752036

Country of ref document: EP

ENP Entry into the national phase

Ref document number: 2014216758

Country of ref document: AU

Date of ref document: 20140214

Kind code of ref document: A

121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 14752036

Country of ref document: EP

Kind code of ref document: A2

ENPC Correction to former announcement of entry into national phase, pct application did not enter into the national phase

Ref country code: GB

REG Reference to national code

Ref country code: BR

Ref legal event code: B01A

Ref document number: 112015019449

Country of ref document: BR

ENP Entry into the national phase

Ref document number: 112015019449

Country of ref document: BR

Kind code of ref document: A2

Effective date: 20150813