Other

Linvatec Corporation

Innovasive Devices, Inc.

James C Chow

Rickey D Hart

F Alan Barber

Gary Garman

A medical instrument (10) is used by a surgeon (S) operating on a patient (P). A surgical implement (12) is held by the surgeon performing the operation and is manipulable by him to bring a portion (14) of the implement into contact with the patient's body (B). A source (16) of ultrasonic pulses (18) produces a stream of such pulses which are supplied to the instrument. The method of the present invention enables pulses to be supplied to the instrument for a defined interval (T.sub.D) after which there is a defined interval (T.sub.E) in which no pulses are delivered. At the end of this pause pulses are again delivered to the instrument. Provision of a pause enable the surgeon to better control the operation, for example, by preventing overcutting of tissue.

Use of pulsed ultrasonics in surgical applications

A bone plug removal and emplacement tool includes a cylindrical cutting element having a proximal cutting edge and a cutting tooth. The outer surface of the cutting element can include an integral shoulder (e.g., in lieu of a replaceable outer sheath) that is spaced-apart from the proximal cutting edge and that engages the surface of the bone to define a depth stop for the cutting edge. An additional cylindrical element can be disposed within the cutting element. The proximal end of that additional element, which is referred to as a 'harvester,' is substantially aligned with the proximal end of the cutting element to receive a plug cut from the bone. The harvester can be slidably withdrawn from the cutting element to facilitate transplating the bone plug at another location. For this purpose, a stem or plunger can be slidably inserted and moved in the harvester to dislodge the plug.

Apparatus and methods for articular cartilage defect repair

A bone plug removal tool is described. The tool includes a cylindrical cutting element having an external surface and having an internal surface defining an internal bore extending along a longitudinal axis of the cutting element from a proximal end to a distal end. A cutting tooth is located at the proximal end of the cutting element and extends into the internal bore. A replaceable outer cylindrical sheath is arranged concentrically around the external surface of the cylindrical cutting element. A bone plug emplacement tool to be used in conjunction the removal tool is also disclosed. The emplacement tool includes a cylindrical element having an internal surface defining an internal bore extending along a longitudinal axis of the element from a proximal end. The internal surface further defines an internal step adjacent a distal end of the element. A stem is disposed for co-axial movement within the element, the stem having a proximal end disposed within the internal bore. A shoulder is defined in the stem for mating engagement with the internal distal step of the element in order to limit distal movement of the stem within the internal bore. A kit incorporating the various tools is disclosed. The kit, for repair of an articular cartilage, includes the bone plug removal tool of the invention, an elongated plunger for insertion into the proximal end of the cutting element and for coaxial movement within it, the plunger for displacing a bone plug from the distal end of cutting element and the bone emplacement tool of the invention. Kits may also include a drill bit containing a depth stop. A method of repairing a defective articular cartilage is also described.

A suture retriever and method for manipulating suture during endoscopic surgical procedures. The suture retriever has an elongated housing provided with a needle tip and a lateral opening situated near the tip. A suture engaging hook is extendable through the lateral opening and away from the axis of the housing in order to snare a suture. The hook is situated at the distal end of an elongated flexible support which is pre-formed in order to enable the hook to be laterally displaced from the axis of the needle tip when the support is moved distally relative to the lateral opening. When a suture is engaged by the hook, the latter is retracted proximally in order to place and hold the suture adjacent the lateral opening.

Endoscopic needle with suture retriever

A surgical kit for performing trigger finger release surgery. A flexor tendon (T) passes through the palm (P) of a person's hand (H) to a finger (F) or thumb (B). Constriction of a protective sheath (E) around the tendon causes the trigger finger condition. For a person suffering from trigger finger, a path (1) of the impaired tendon is first identified. A puncture site is then located for insertion of one end of a hollow, curved cannula (1) into the palm. The cannula is pushed through the palm with a first puncture hole (U) being made where the instrument enters into the palm, and a second puncture hole (U') where the cannula exits from the palm. The cannula is routed through the palm such that the path (8) of the cannula passes through the sheath. The cannula is left in place and an arthroscope (9) and a surgical knife (11) are inserted into respective ends of the instrument. The surgeon views the surgical site through a monitor (10) to which the arthroscope is attached. The knife has a cutting blade brought to bear by the surgeon on the sheath. The cannula has a longitudinally extending slot (2) through which the surgeon both views the site and moves the knife against the sheath. After the surgery is complete, the arthroscope and knife are removed from the cannula and the cannula is withdrawn from the palm. The size of the cannula is such that after its withdrawal, the puncture wounds made do not require stitches to close them. As the wounds heal, no scars are formed.

Endoscopic surgical kit for release of trigger finger

A method for closing an incision (I) deep within a patient's body (B) with a suture (S). A medical instrument (C) has arms 1 and 2 for openings and closing opposed jaws (3,4). Each jaw has a pair of openings (3A-3B, 4A-4B). A knot (K) is formed using the ends (S1, S2) of the suture. For this purpose, the ends of the suture are withdrawn from the body. This allows the surgeon to form a proper surgical knot. After forming the knot, the suture ends are inserted through the respective Fairs of openings. The surgeon can now draw the knot tightly down on the incision to close it by inserting the jaws end of the instrument into the patient's body while applying a slight pulling force on the ends of the suture. The surgical knot thus made will not thereafter loosen.

Arthroscopic knot tying device

An endoscopic method and system are provided which include a guide member, or sheath, open at both ends and having a continuous opening in the sheath along its entire length. A trocar proportioned to fit within the sheath includes a prominence which fits within the opening of the sheath to provide a smooth surface on the exterior of the sheath for insertion into, for example, a hand for the endoscopic release of the carpal ligament. The trocar is removed and a videoarthroscope is inserted in one end of the sheath while a cutting instrument or other instrument is inserted in the opposite end to permit direct observation of the procedure.

Cutting instruments for endoscopic surgery

A method of performing trigger finger release surgery. A flexor tendon (T) passes through the palm (P) of a person's hand (H) to a finger (F) or thumb (B) . For a person suffering from trigger finger, the path (1) of the impaired tendon is first identified. Constriction of a protective sheath (E) around the flexor tendon causes the trigger finger condition. A puncture site is identified for insertion of one end of a hollow surgical instrument (1) into the palm. The surgical instrument is pushed through the palm of the hand so that a first puncture hole (U) is made where the instrument enters into the palm, and a second puncture hold (U') where the instrument exits from the palm. The instrument is routed through the palm such that the path (8) of the instrument passes through the sheath. The surgical instrument is left in place and an arthroscope (9) and a surgical knife (11) are inserted into respective ends of the instrument. The surgeon views the surgical site through a monitor (10) while cutting the sheath with the knife. The arthroscope, knife, and surgical instrument are then withdrawn. The size of the surgical instrument is such that after its withdrawal, the puncture holes made in the hand do not require stitches to close them. As the wounds heal, no scars are formed.

Trigger finger release surgical method

A method for closing an incision (I) deep within a patient's body (B) with a suture (S). A medical instrument (C) has arms 1 and 2 for openings and closing opposed jaws (3,4). Each jaw has a pair of openings (3A-3B, 4A-4B). A knot (K) is formed using the ends (S1, S2) of the suture. For this purpose, the ends of the suture are withdrawn from the body. This allows the surgeon to form a proper surgical knot. After forming the knot, the suture ends are inserted through the respective pairs of openings. The surgeon can now draw the knot tightly down on the incision to close it by inserting the jaws end of the instrument into the patient's body while applying a slight pulling force on the ends of the suture. The surgical knot thus made will not thereafter loosen.

Cutting instrument for endoscopic surgery

A surgical implement (10) for permanently attaching a ligament (L) or a suture to a bone (B). An anchor body (12) is insertable into a pre-drilled hole (H). The outer end of the body is threaded onto a hollow tube (T) which is used to insert the anchor body into the hole. The body has a recess (18) at its inner end for capturing the ligament or suture prior to insertion of the body into the hole. The anchor body has a longitudinally extending bore (14) into which a pin 15 is inserted through the tool. Fins (16a, 16b) on opposite sides of the body extend into the opening in the body but are forced outwardly by the pin as it is inserted in the bore. The fins engage the sidewall of the hole and prevent the anchor body from being dislodged. Because the fins are not pushed outwardly unless the pin is inserted, the anchor body can be trial fit into the hole without it being permanently installed. Thus, if the hole is not suitable, another hole can be drilled and the ligament or suture is permanently attached to the bone only at a suitable site.

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Mount Vernon, IL, United States of America

James C Chow