WO2019006259A1 - Dispositif de dissection - Google Patents

Dispositif de dissection Download PDF

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Publication number
WO2019006259A1
WO2019006259A1 PCT/US2018/040223 US2018040223W WO2019006259A1 WO 2019006259 A1 WO2019006259 A1 WO 2019006259A1 US 2018040223 W US2018040223 W US 2018040223W WO 2019006259 A1 WO2019006259 A1 WO 2019006259A1
Authority
WO
WIPO (PCT)
Prior art keywords
dissecting
dissecting arm
segment
arm segments
wire
Prior art date
Application number
PCT/US2018/040223
Other languages
English (en)
Inventor
Jill ONESTI
Zach BLETT
Bryce FOWLER
Alexandria GRAFF
Ryan HAEFNER
Phillip KESHAVARZI
Alex ROH
Henry Schaub
Shane Sullivan
John Farris
Chris PUNG
Original Assignee
Onesti Jill
Blett Zach
Fowler Bryce
Graff Alexandria
Haefner Ryan
Keshavarzi Phillip
Roh Alex
Henry Schaub
Shane Sullivan
John Farris
Pung Chris
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
Application filed by Onesti Jill, Blett Zach, Fowler Bryce, Graff Alexandria, Haefner Ryan, Keshavarzi Phillip, Roh Alex, Henry Schaub, Shane Sullivan, John Farris, Pung Chris filed Critical Onesti Jill
Publication of WO2019006259A1 publication Critical patent/WO2019006259A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00818—Treatment of the gastro-intestinal system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320044—Blunt dissectors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B2017/32006—Surgical cutting instruments with a cutting strip, band or chain, e.g. like a chainsaw

Definitions

  • the present disclosure generally relates to dissection devices, such as devices that may be used in connection with removing portions of a human esophagus.
  • a dissection device may include a guide assembly and a dissector assembly.
  • the guide assembly may include an outer tube and an inner tube disposed at least partially in the outer tube.
  • the dissector assembly may be configured to be inserted through the inner tube.
  • the dissector assembly may include a control box, a connecting tube, and a dissecting arm.
  • the dissecting arm may include a plurality of dissecting arm segments connected to each other, wherein adjacent dissecting arm segments are configured to rotate relative to each other.
  • FIG. 1A is a cross-sectional view generally illustrating a human body with an undissected esophagus.
  • FIG. IB is a cross-sectional view generally illustrating a human body with a dissected esophagus.
  • FIGS. 2A and 2B are perspective views generally illustrating embodiments of guide assemblies of dissection devices according to teachings of the present disclosure.
  • FIG. 3 is a perspective view generally illustrating an embodiment of a dissector assembly of a dissection device according to teachings of the present disclosure.
  • FIGS. 4, 5, 6, 7, 8A, 8B, 8C, 8D, 9A, and 9B are perspective views generally illustrating portions of embodiments of guide assemblies of dissection devices according to teachings of the present disclosure.
  • FIG. 10 is an exploded perspective view generally illustrating portions of an embodiment of a guide assembly of a dissection device according to teachings of the present disclosure.
  • FIGS. 11 A, 11B, 12A, 12B, 13A, and 13B are perspective views generally illustrating portions of embodiments of dissector assemblies of dissection devices according to teachings of the present disclosure.
  • FIGS. 14A, 14B, and 14C are side views of embodiments of dissecting arm segments of dissector assemblies according to teachings of the present disclosure.
  • FIG. 14D is a perspective view of a dissecting arm segment of a dissector assembly according to teachings of the present disclosure.
  • FIGS. 15A, 15B, and 15C are side views of embodiments of dissecting arm end segments of dissector assemblies according to teachings of the present disclosure.
  • FIG. 15D is a perspective view of an embodiment of a dissecting arm end segment of a dissector assembly according to teachings of the present disclosure.
  • FIGS. 16A, 16B, 16C, and 16D are side views of embodiments of tube adapters of dissector assemblies according to teachings of the present disclosure.
  • FIG. 16E is a perspective view of an embodiment of a tube adapter of a dissector assembly according to teachings of the present disclosure.
  • FIGS. 17A, 17B, 17C, and 17D are side views of embodiments of hinge segments of dissector assemblies according to teachings of the present disclosure.
  • FIG. 17E is a perspective view of a hinge segment of a dissector assembly according to teachings of the present disclosure.
  • FIG. 18 is an exploded perspective view of a control housing of a dissector assembly according to teachings of the present disclosure.
  • FIGS. 19A, 19B, and 19C are side views of embodiments of control box housings of dissector assemblies according to teachings of the present disclosure.
  • FIG. 19D is a perspective view of a control box housing of a dissector assembly according to teachings of the present disclosure.
  • FIG. 20 is a perspective view of a control box housing cover of a dissector assembly according to teachings of the present disclosure.
  • FIGS. 21A, 21B, 21C, and 21D are side views of embodiments of wire rotators of dissector assemblies according to teachings of the present disclosure.
  • FIG. 21E is a perspective view of a wire rotator of a dissector assembly according to teachings of the present disclosure.
  • FIGS. 22A, 22B, and 22C are side views of embodiments of ratchet adapters of dissector assemblies according to teachings of the present disclosure.
  • FIG. 22D is a perspective view of a ratchet adapter of a dissector assembly according to teachings of the present disclosure.
  • FIG. 23 is a perspective view of a control knob of a dissector assembly according to teachings of the present disclosure. DETAILED DESCRIPTION
  • a human body 30 may include a diaphragm 32, a stomach 34, and an esophagus 36.
  • the stomach 34 may be disposed in the diaphragm 32 and the esophagus 36 may extend into the diaphragm 32 via a diaphragmatic hiatus 38.
  • the esophagus 36 may be connected in the body 30 (e.g., in the mediastinum) via connecting tissue 40.
  • a section 36R of an esophagus 36 may be removed/dissected.
  • Some methods of performing an esophagectomy may dissect esophageal tissue, but the methods may be relatively invasive, time consuming, and/or require a surgeon to place his/her hand and arm into a patient's torso for manual dissection.
  • Manual dissection may rely heavily on the practice and skill of the surgeon and/or involve repeatedly checking for connecting tissue that has not been dissected.
  • FIG. IB after removal/dissection, the remaining portions of the esophagus 36 may be connected together and/or to the stomach 34.
  • a dissection device 50 may include a guide assembly 52 and/or, as generally illustrated in FIG. 3, may include a dissector assembly 54.
  • the guide assembly 52 may be configured for insertion into the body 30 and may guide insertion of the dissector assembly 54 through the body 30 to the element or portion to be dissected (e.g., the esophagus 36).
  • a guide assembly 52 may include an outer tube 60 and an inner tube 62 disposed at least partially in the outer tube 60.
  • the outer tube 60 may include a bend 64, such as, for example only, a bend of about 120 degrees.
  • the outer tube 60 may be relatively rigid and the inner tube 62 may be relatively flexible.
  • the inner tube 62 may be connected to move relative to the outer tube 60.
  • the inner tube 62 may move in a telescoping manner into and out of the outer tube 60.
  • At least a portion of the inner tube 62 may remain in the outer tube 60, even in a fully extended position of the inner tube 62. Movement/extension of the inner tube 62 may allow for the guide assembly 52 to compensate for different-sized applications (e.g., human patients of different sizes).
  • a guide assembly 52 may include a drive assembly 70 that may control movement/extension of the inner tube 62 relative to the outer tube 60 and/or an orientation of the inner tube 62.
  • the drive assembly 70 may include a gear housing 72, a gear 74, a pawl 76, a gear housing cover 78, and/or a guide assembly cap 80.
  • the gear 74 and the pawl 76 may be disposed in the gear housing 72 and/or may provide ratchet functionality.
  • the outer tube 60 may extend through the gear housing 72 and/or the gear housing 72 may be connected to the outer tube 60.
  • Rotation of the gear housing 72 and/or the gear 74 may cause movement of a drive wire 82.
  • the drive wire 82 may be connected to the inner tube 62 and the gear housing 72 such that movement of the drive wire 82 may cause movement of the inner tube 62 (e.g., translation, rotation, articulation, etc.).
  • the inner tube 62 may be moved into and/or out of the outer tube 60 via the guide assembly cap 80, which may be connected and/or fixed to the inner tube 62.
  • the guide assembly cap 80 may engage a track 84 of the outer tube 60.
  • the track 84 may include one or more engagement sections/formations 86 that may correspond to various positions of the inner tube 62 relative to the outer tube 60.
  • the guide assembly cap 80 may include an inner protrusion 88 that may engage the engagement sections/formations 86 of the track 84.
  • the guide assembly cap 80 may be configured to lock the inner tube 62 relative to the outer tube 60, such as via the inner protrusion 88 engaging the track 84.
  • a guide assembly 52 may be configured for insertion into a human body 30 via the abdomen and/or may be inserted to a diaphragmatic hiatus 38.
  • the guide assembly 52 may include a retainer 100 that may be configured to retain the guide assembly 52 at or about the diaphragmatic hiatus 38.
  • a retainer 100 may include, for example, an inflatable portion 102, such as a balloon.
  • the balloon 102 may be selectively inflatable such that during insertion and removal, the balloon 102 may be not be inflated (e.g., to reduce an outer diameter of the guide assembly 52) and during use, the balloon 102 may be inflated to retain a guide assembly 52 in a position relative to the diaphragmatic hiatus 38.
  • the balloon 102 may include a spool-like shape that may be configured to straddle the diaphragmatic hiatus 38 and may include a first flange 104 configured to be disposed at a first side of the diaphragmatic hiatus 38 (e.g., outside the diaphragm 32) and a second flange 106 that may be configured to be disposed at a second side of the diaphragmatic hiatus 38 (e.g. inside the diaphragm 32).
  • the first flange 104 and the second flange 106 may be axially spaced from each other.
  • the balloon 102 When inflated, the balloon 102 may engage the diaphragm 32 and/or the diaphragmatic hiatus 38 to retain the guide assembly 52.
  • the guide assembly 52 may include a fluid line 108 configured to provide air (or some other inflating fluid) to the balloon 102 and/or remove air from the balloon 102.
  • the fluid line 108 may be connected to and/or fixed to the inner tube 62.
  • a dissector assembly 54 may be configured for insertion through a guide assembly 52 and/or for dissecting portions of a body 30 (e.g., a section 36R of an esophagus 36).
  • a dissector assembly 54 may include a control box 120, a connecting tube 122, a dissecting arm 126, and/or one or more control wires (e.g., control wires 130A, 130B).
  • the connecting tube 122 may connect the control box 120 with the dissecting arm 126.
  • the control box 120 may control one or more control wires 130A, 130B that may control movement of the dissecting arm 126, such as between an insertion position (see, e.g., FIG. 11 A) and a dissecting position (see, e.g., FIGS. 3 and 11B).
  • a dissecting arm 126 may include one or more arm segments 140 that may be movably connected to each other.
  • a dissecting arm 126 may include a plurality of segments 140 that may be rotatably connected end-to-end such that they may rotate between (i) a first/insertion position in which the segments 140 may be generally aligned in a linear/insertion configuration (see, e.g., FIGS 11A and 12B) and (ii) a second/dissecting position in which at least a number of the segments are aligned in a generally circular configuration in a plane perpendicular to the tube axis 122A (see, e.g., FIGS.
  • outer dimensions of the segments 140 may be less than an inner diameter of an inner tube 62 of a guide assembly 52 so that the dissecting arm 126 and the connecting tube 122 may be inserted through the inner tube 62.
  • an outer dimension or diameter 126Di of the dissecting arm 126 may be less than about 15 mm in a linear configuration and an inner diameter of the inner tube 62 of the guide assembly 52 may be at least about 19 mm.
  • outer dimensions of the dissecting arm 126 may be greater than an inner diameter of the inner tube 62 of a guide assembly 52.
  • an outer diameter 126D 2 of the dissecting arm segments 140 in a circular configuration may be about 22 mm.
  • a dissecting arm 126 may be connected with the connecting tube 122 via a tube adapter 144 and/or a hinge segment 146.
  • the tube adapter 144 may include a first end 148 that may connect with the connecting tube 122 and/or a second end 150 that may include a hinge 152 that may rotatably connect with a hinge segment 146.
  • the tube adapter 144 may be connected to the connecting tube 122 such that the tube adapter 144 and the connecting tube 122 do not move relative to each other. Examples of embodiments of hinge segments 146 are generally illustrated in FIGS. 17A- 17E.
  • a hinge segment 146 may connect with one or more of the segments 140 of the dissecting arm 126.
  • a hinge segment 146 may rotate relative to the tube adapter 144 via the hinge 152 about a hinge axis 152A that may be disposed perpendicularly to a longitudinal axis 122A of the connecting tube 122.
  • a hinge segment 146 may rotate between a linear orientation (see, e.g., FIG. 11 A) and a perpendicular orientation (see, FIGS. 11B, 13A, and 13B). For example and without limitation, the hinge segment 146 may rotate about 90 degrees.
  • a hinge segment 146 may have, for example, a generally planar configuration and may rotate between a parallel position in which a plane of the hinge segment 146 is disposed substantially parallel with a longitudinal axis 122A of the connecting tube 122 and a perpendicular position in which a plane of the hinge segment 146 is disposed substantially perpendicular to the tube axis 122A.
  • the hinge axis 152A may be disposed perpendicular to segment axes 140A of the dissecting arm segments 140 in one or both of a linear position of the dissecting arm 126 and a substantially perpendicular circular position of the dissecting arm 126.
  • a hinge segment 146 may include a first/inner aperture 146 A and/or a second/outer aperture 146B.
  • the first control wire 130A may extend through the first aperture 146 A and/or the second control wire 130B may extend through the second aperture.
  • rotation of the hinge segment 146 relative to the tube adapter 144 about a hinge axis 152A may result in the dissecting arm 126 rotating from a linear orientation to a generally perpendicular orientation.
  • the dissecting arm segments 140 may rotate about segment axes 140A.
  • segment axes 140A may be disposed substantially perpendicularly to the connecting tube axis 122A (see, e.g., FIG. 11A).
  • segment axes 140A may be disposed substantially in parallel with the tube axis 122A, the dissecting arm segments 140 may be disposed in/aligned with a plane perpendicular to the longitudinal axis 122A of the connecting tube 122, and/or an arm axis 126A extending through a center of a circular configuration of the arm segments 140 may extend in parallel with the tube axis 122A (see, e.g., FIG. 11B).
  • a dissecting arm segment 140 may include one or more of a variety of shapes, sizes, configurations, and/or materials.
  • a dissecting arm segment 140 may be generally box-shaped with inner and/or outer curved portions.
  • a dissecting arm segment 140 may, for example, include a generally triangular cross-section.
  • adjacent segments may be connected via corresponding forks 160 and tabs 162 that may be coupled via a fastener 164, such as a nut and bolt, a rivet, and/or another fastener/connector.
  • a dissecting arm segment 140 may include a fork 160 at a first side and a tab 162 at a second, opposite side.
  • the fork 160 may be configured to connect the dissecting arm segment 140 with a first other dissecting arm segment 140 (and/or a hinge segment 146) and the tab 162 may be configured to connect the dissecting arm segment 140 with a second other dissecting arm segment 140.
  • the dissecting arm segments 140 may include rounded outer surfaces and/or may provide a relatively blunt dissecting surface.
  • a dissecting arm 126 may include, for example and without limitation, seven total dissecting arm segments 140, which may include an end segment 170, and may include other numbers of dissecting arm segments 140.
  • a dissecting arm 126 may include, for example and without limitation, at least five, or at least six total dissecting arm segments 140, which may respectively include an end segment.
  • an end segment 170 of the dissecting arm segments 140 may include a different configuration from other and/or a remainder of segments 140.
  • an end segment 170 may include one or more protrusions (e.g., protrusions 172A, 172B) that may be configured to extend at least partially around another segment (e.g., the first segment 140 connected with the hinge segment 146, and/or the hinge segment 146).
  • the one or more protrusions 172 A, 172B may provide a U-shaped portion that may be configured to at least partially receive one or more other segments, such as the first segment 140 connected with the hinge segment 146 and/or the hinge segment 146.
  • the dissecting arm segments 140 may form a complete/closed circle, which may include the end segment 170 overlapping with one or more segments 140 and/or the hinge segment 146, such as for completely encircling an esophagus 36.
  • a hinge segment 146 may include a first tab 146C and/or a second tab 146D that may be disposed at opposite ends of the hinge segment 146.
  • the first tab 146C may be configured for connection with a fork 160 of a dissecting arm segment 140 and/or may include a configuration that may be similar to and/or substantially the same as a tab 162.
  • the second tab 146D may be configured for connection with a hinge 152.
  • the second tab 146D may include a similar configuration as the first tab 146C and may be disposed substantially perpendicular to the first tab 146C.
  • a hinge segment 146 may include a flange 146E that may extend outward (e.g., perpendicular) from a surface of the hinge segment.
  • the flange 146E may be disposed such that in a perpendicular/dissecting position of the dissecting arm 126, the flange 146E may abut the hinge 152 and/or limit rotation of the hinge segment 146. In a linear/insertion position, the flange 146E may not be in contact with the hinge 152 and/or any part of the tube adapter 144.
  • a control box 120 may include a housing 180, a cover 182, a rod 184, a control knob 186, a wire rotator 188, a ratchet adapter 190, and/or one or more nuts 192.
  • a control box 120 may be configured to control movement of one or more control wires 130 A, 130B that may control movement of the dissecting arm 126.
  • the rod 184 may be disposed at least partially in the housing 180 and the wire rotator 188 may be connected with the rod 184 such that rotation of the rod 184 may cause rotation of the wire rotator 188.
  • the wire rotator 188 may cause a first control wire 130A to wind up on the wire rotator 188, which may cause a length of the first wire 13 OA outside of the control box 120 to shorten. Additionally or alternatively, as the wire rotator 188 rotates in the first direction, it may cause a second control 130B wire to unwind/unwrap from the wire rotator 188, which may permit or cause a length of the second wire 130B outside of the control box 120 to increase. As the wire rotator 188 rotates in a second (e.g., opposite) direction, the first control wire 130A may unwind/unwrap while the second control wire 13 OB may wind around the wire rotator 188. The wire rotator 188 may control the control wires 130A, 13 OB in opposite directions.
  • a control knob 186 may be connected with the rod 184 to facilitate rotation of the rod 184 and the wire rotator 188.
  • the nuts 192 may be configured to fix the wire rotator 188 to the rod 184 and/or to limit rotation of the rod 184.
  • a ratchet adapter 190 may be connected to the rod 184 and/or one or more of the nuts 192 and may be configured to facilitate a connection of a ratchet wrench to rotate the rod 184 (e.g., in addition to and/or as alternative to the control knob 186).
  • a dissector assembly 54 may include a first/inner control wire 130A and/or a second/outer control wire 130B.
  • a control wire 130A, 130B may include one or more of a variety of shapes, sizes, configurations, and/or materials, and may include, for example only, a metal wire and/or a metal cable, among other things.
  • the first control wire 130A and/or the second control wire 130B may be connected to the wire rotator 188, extend through a connecting tube 122, extend through the tube adapter 144, extend through the hinge segment 146, extend through one or more dissecting arm segments 140, and/or may be connected to the end segment 170.
  • a first control wire 130A may, for example, extend through inner apertures 200 of the dissecting arm segments 140 and may be connected and/or fixed to the end segment 170.
  • a second control wire 130B may, for example, extend through outer apertures 204 of the dissecting arm segments 140 and may be connected and/or fixed to the end segment 170.
  • the dissecting arm segments 140 may include outer portions 206 and inner portions 202. In the linear/insertion position, outer portions 206 of the dissecting arm segments 140 may be disposed in contact with each other. In the dissection position, inner portions 202 of the dissecting arm segments 140 may disposed in contact with each other.
  • movement of the first wire 130A and/or the second wire 130B may control movement of at least a portion of a dissecting arm 126, such as between a linear orientation and a perpendicular/circular orientation.
  • a dissecting arm 126 may initially be disposed in a linear orientation and rotating the control knob 186 in a first direction may cause (i) the first wire 130A to wind around the wire rotator 188, (ii) the second wire 130B to unwind from the wire rotator 188, (iii) the first wire 130A to pull on one or more dissecting arm segments 140 (e.g., the end segment 170) inward, (iv) the hinge segment 146 to rotate relative to the hinge 152, and/or (v) the dissecting arm segments 140 to rotate about the segment axes 140 A to form a ring-shaped configuration.
  • dissecting arm segments 140 e.g., the end segment 170
  • a ring-shaped configuration may correspond to the shape of an esophagus 36 and/or movement of the dissecting arm 126 from a linear orientation to a perpendicular/circular orientation may include wrapping partially and/or entirely around an esophagus 36.
  • Dissecting arm segments 140 may, for example, provide an inner diameter that is about the same as an outer diameter of the esophagus 36, at least in a perpendicular/circular orientation of the dissecting arm 126.
  • rotation of a control knob 186 in a second (e.g. opposite) direction may cause (i) the first wire 130A to unwind from the wire rotator 188, (ii) the second wire 130B to wind around the wire rotator 188, (iii) the second wire 130B to pull on one or more dissecting arm segments 140 (e.g., the end segment 170) outward, (iv) the hinge segment 146 to rotate relative to the hinge 152 (e.g., from a perpendicular orientation to a parallel orientation), and/or (v) the dissecting arm segments 140 to rotate about the segment axes 140A to provide the linear orientation.
  • dissecting arm segments 140 e.g., the end segment 170
  • a guide assembly 52 may be inserted into a body 30 (e.g., a human body) and an inner tube 62 may be adjusted to a length/angle corresponding to the size/shape of the body 30.
  • the guide assembly 52 may be inserted until the balloon 102 is aligned with the diaphragmatic hiatus 38 and a balloon 102 may be inflated to retain the guide assembly 52 in position.
  • the dissector assembly 54 may be inserted into the guide assembly 52 and through to the section 36R of the esophagus 36 intended to be dissected.
  • a control knob 186 may be rotated to cause a wire (e.g., wire 130A) to wind around a wire rotator 188, which may cause a dissecting arm 126 to move from a linear orientation to a circular orientation partially and/or entirely encircling an esophagus 36.
  • a dissector assembly 54 may be inserted further and the dissecting arm 126 may dissect connecting tissue 40 from an esophagus 36 (e.g., as the dissecting arm 126 slides along the esophagus 36, the dissecting arm 126 may dissect and/or disconnect connecting tissue 40 from the esophagus 36 and/or from the body 30).
  • removing a dissector assembly 54 from a body 30 and/or a guide assembly 52 may include rotating a control knob 186 to cause a different wire (e.g., wire 130B) to wind around the wire rotator 188, which may cause the dissecting arm 126 to move from a circular orientation to a linear orientation. While the wire 130B winds around the wire rotator 188, another wire (e.g., wire 130A) may unwind from the wire rotator 188. The dissector assembly 54 may then slide through and out of the guide assembly 52. The balloon 102 may be deflated, at least to some degree, and the guide assembly 52 may be removed from the body 30.
  • a different wire e.g., wire 130B
  • another wire e.g., wire 130A
  • the dissector assembly 54 may then slide through and out of the guide assembly 52.
  • the balloon 102 may be deflated, at least to some degree, and the guide assembly 52 may be removed from the body 30.
  • references to a single element are not necessarily so limited and may include one or more of such element. Any directional references (e.g., plus, minus, upper, lower, upward, downward, left, right, leftward, rightward, top, bottom, above, below, vertical, horizontal, clockwise, and counterclockwise) are only used for identification purposes to aid the reader's understanding of the present disclosure, and do not create limitations, particularly as to the position, orientation, or use of embodiments.
  • joinder references are to be construed broadly and may include intermediate members between a connection of elements and relative movement between elements. As such, joinder references do not necessarily imply that two elements are directly connected/coupled and in fixed relation to each other.
  • the use of "e.g.” in the specification is to be construed broadly and is used to provide non-limiting examples of embodiments of the disclosure, and the disclosure is not limited to such examples.
  • Uses of "and” and “or” are to be construed broadly (e.g., to be treated as "and/or”). For example and without limitation, uses of "and” do not necessarily require all elements or features listed, and uses of "or” are intended to be inclusive unless such a construction would be illogical.

Abstract

L'invention concerne un dispositif de dissection qui comprend un ensemble guide et un ensemble dissecteur. L'ensemble guide peut comprendre un tube externe et un tube interne disposé au moins partiellement dans le tube externe. L'ensemble dissecteur peut être conçu pour être inséré à travers le tube interne. L'ensemble dissecteur peut comprendre une boîte de commande, un tube de raccordement et un bras de dissection. Le bras de dissection peut comprendre une pluralité de segments de bras de dissection reliés entre eux, des segments de bras de dissection adjacents étant conçus pour tourner l'un par rapport à l'autre.
PCT/US2018/040223 2017-06-30 2018-06-29 Dispositif de dissection WO2019006259A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201762527323P 2017-06-30 2017-06-30
US62/527,323 2017-06-30

Publications (1)

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WO2019006259A1 true WO2019006259A1 (fr) 2019-01-03

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Application Number Title Priority Date Filing Date
PCT/US2018/040223 WO2019006259A1 (fr) 2017-06-30 2018-06-29 Dispositif de dissection

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WO (1) WO2019006259A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5224945A (en) * 1992-01-13 1993-07-06 Interventional Technologies, Inc. Compressible/expandable atherectomy cutter
US20020007190A1 (en) * 2000-04-05 2002-01-17 Wulfman Edward I. Intralumenal material removal systems and methods
US20020016624A1 (en) * 1997-02-12 2002-02-07 Prolific Medical, Inc. Apparatus and method for controlled removal of stenotic material from stents
US20020165580A1 (en) * 2001-05-03 2002-11-07 Aaron Zwiefel Biopsy forceps device with transparent outer sheath
US20110178523A1 (en) * 2008-07-27 2011-07-21 Nonlinear Technologies Ltd. Tool and corresponding method for removal of material from within a body

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5224945A (en) * 1992-01-13 1993-07-06 Interventional Technologies, Inc. Compressible/expandable atherectomy cutter
US20020016624A1 (en) * 1997-02-12 2002-02-07 Prolific Medical, Inc. Apparatus and method for controlled removal of stenotic material from stents
US20020007190A1 (en) * 2000-04-05 2002-01-17 Wulfman Edward I. Intralumenal material removal systems and methods
US20020165580A1 (en) * 2001-05-03 2002-11-07 Aaron Zwiefel Biopsy forceps device with transparent outer sheath
US20110178523A1 (en) * 2008-07-27 2011-07-21 Nonlinear Technologies Ltd. Tool and corresponding method for removal of material from within a body

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