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Coordinate instrument setRelated Patent Categories: Surgery, Diagnostic Testing, Measuring Anatomical Characteristic Or Force Applied To Or Exerted By BodyCoordinate instrument set description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20060211953, Coordinate instrument set. Brief Patent Description - Full Patent Description - Patent Application Claims
[0001] This application claims the benefit of U.S. Provisional Application No. 60/623,624 filed on Oct. 29, 2004, by Anthony D. Zannis, Herbert E. Schwartz, Prasanna Malaviya, Keith M. McGrath, Danny E. McAdams, Andrew M. Jacobs, Jack Farr, II and Randall L. Holcomb entitled "Coordinate Instrument Set," which is incorporated by reference herein in its entirety. FIELD OF THE INVENTION [0002] The present invention relates to surgical instruments and more particularly to surgical instrument sets that can be used to measure and map defects and to monitor the effects of a treatment regime over time. BACKGROUND OF THE INVENTION [0003] Various types of Minimally Invasive Surgery ("MIS") are being performed by surgeons, including laparoscopy, endoscopy and arthroscopy surgery. In arthroscopy, small incisions are made at the affected joint to form portals for the insertion of instruments, including a small lens and lighting system (an arthroscope). The arthroscope is connected to a viewing device, such as a television camera to allow the surgeon to see the interior of the joint. Other instruments are inserted through other portals to perform a variety of tasks. For example, the surgical instrument may include an implement for manipulating native tissue (for example, tissue grasping, tissue cutting, bone abrading), or an implement for introducing and implanting a therapeutic device. [0004] Typical surgical instruments used in arthroscopic procedures include rongeurs, such as the Kerrison rongeur, punch forceps, basket forceps, suction punches and cup curette, for example. Examples of arthroscopic instruments are described and illustrated in O'Connor's Textbook of Arthroscopic Surgery, 2.sup.nd ed., 1992, Chapter 19. [0005] In many surgical settings, it is often necessary for the surgeon to make measurements between two points. Due to the confined spaces of arthroscopic surgery, measuring such distances is often quite difficult, particularly when the measurement needed is larger than the size of the incision or transverse to the direction of the incision. Arthroscopic knee surgery provides many such situations. For example, it may be helpful if a surgeon could measure the size of a defect in the meniscus of a knee, to aid in choosing the appropriate method to repair the defect. [0006] An arthroscopic measuring device is disclosed in U.S. Pat. No. 6,427,351B1, which is incorporated by reference herein in its entirety. The device disclosed in that patent provides a handle and an extension. The extension has a distal tip for intraoperative insertion into the body through an incision. Two wires extend from a block in the handle through passageways in two separate tubes that comprise the extension. The block is connected to an actuator element. The actuator elements disclosed can be moved back and forth in a direction parallel to the longitudinal axis of the handle to move the wires out of an into the tubes. At their distal ends, the tubes diverge at a fixed angle so that the distance between the ends of the wires increases as the wires are pushed further outward and decreases as the wires are pulled back into the handle. Calibrations on the handle correspond with the distance between the ends of the wires so that the surgeon can determine one or more of the dimensions of a defect in the bone or cartilage. [0007] Although the arthroscopic measuring device disclosed in U.S. Pat. No. 6,427,351B1 provides a useful surgical tool, operation of the actuating mechanism disclosed can be difficult for the surgeon, particularly due to friction as the wires are pushed through the divergent tube endings. In addition, use of that device may require that the surgeon use both hands to hold the handle and move the actuating mechanism. Finally, use of that device may not allow for repeatable measurements of the tissue and changes in the tissue over time. [0008] Determining the size and location of a defect at a tissue site, such as the meniscus of the knee joint, can be useful in several arthroscopic procedures. [0009] Common surgical procedures for treating meniscal damage include tear repairs and meniscectomies. A tear repair is most commonly performed when the tear is a clean longitudinal vertical lesion in the vascular red zone of the meniscus. The basic strategy is to stabilize the tear by limiting or eliminating radial separation of the faces of the tear when the meniscus is load bearing. Many devices and surgical procedures exist for repairing meniscal tears by approximating the faces of the meniscus at the tear. Examples of such devices and procedures are disclosed in the following U.S. Pat. Nos.: 6,319,271; 6,306,159; 6,306,156; 6,293,961; 6,156,044; 6,152,935; 6,056,778; 5,993,475; 5,980,524; 5,702,462; 5,569,252; 5,374,268; 5,320,633; and 4,873,976. [0010] Meniscectomies involve the surgical removal of part of the meniscus. Such procedures have generally been performed in cases of radial tears, horizontal tears, vertical longitudinal tears outside the vascular zone, complex tears, or defibrillation. Although meniscectomies provide immediate relief to the patient, in the long term the absence of part of the meniscus can cause cartilage wear on the condylar surface, eventually leading to arthritic conditions in the joint. [0011] A variety of orthopaedic implants are available for treating damaged soft tissue. Orthopaedic implants for treatment of damaged menisci are disclosed in the following U.S. Pat. Nos.: 6,042,610; 5,735,903; 5,681,353; 5,306,311; 5,108,438; 5,007,934; and 4,880,429. [0012] In tear repairs, meniscectomies, and in treatments involving the use of implants, there exists a need for instruments that not only allow for measurement of the sizes of the defects, but also for mapping the defect in a repeatable manner so that the clinical results of the treatment can be monitored over time. SUMMARY OF THE INVENTION [0013] The present invention provides an instrument set and a surgical technique for mapping the location of a tissue defect, or the location of an implant, over time, and for measuring the defect intra-operatively. [0014] In one aspect, the present invention provides a surgical instrument having a proximal end and a distal end. The surgical instrument comprises a tube and a ruler. The tube has a proximal end, a distal end, and an elongate channel, The ruler has a proximal end, a distal end, a straight portion received within the channel of the tube, a measurement portion between the straight portion and the distal end and an anchoring tip at the distal end. The measurement portion of the ruler includes distance indicia. The anchoring tip has a pointed end. The measurement portion of the ruler lies in a plane. The pointed-end of the anchoring tip is spaced from the plane of the measurement portion of the ruler. The ruler is reciprocable in a proximal-distal direction with respect to the tube between a retracted position and an extended position. [0015] In another aspect, the present invention provides a surgical instrument having a proximal end and a distal end. The surgical instrument comprises a tube and a ruler. The tube has a proximal end, a distal end, and an elongate channel. The ruler has a proximal end, a distal end, a straight portion received within the channel of the tube, a measurement portion between the straight portion and the distal end and a hook at the distal end. The measurement portion of the ruler includes distance indicia. The ruler is reciprocable in a proximal-distal direction with respect to the tube between a retracted position and an extended position. [0016] In another aspect, the present invention provides a surgical instrument set comprising first and second surgical instruments. Each surgical instrument has a proximal end and a distal end, and each surgical instrument comprises a tube and a ruler. The tube of each surgical instrument has a proximal end, a distal end and a channel extending from the proximal to the distal end. The ruler of each surgical instrument has a proximal end, a distal end, a measurement portion between the proximal end and the distal end and a straight portion between the measurement portion and the proximal end. The measurement portion includes distance indicia. The straight portion of the ruler of each surgical instrument has a longitudinal axis. The ruler of each surgical instrument is reciprocable in a proximal-distal direction with respect to the tube between a retracted position and an extended position. The distal end of the ruler of the first surgical instrument comprises an anchoring tip. The anchoring tip has a pointed end. The distal end of the ruler of the second surgical instrument comprises a hook. [0017] In another aspect, the present invention provides a surgical instrument set comprising a plurality of surgical instruments. Each surgical instrument has a proximal end and a distal end, and each surgical instrument comprises a tube and a ruler. The tube of each surgical instrument has a proximal end, a distal end and a channel extending from the proximal to the distal end. The ruler of each surgical instrument has a proximal end, a distal end, a measurement portion between the proximal end and the distal end and a straight portion between the measurement portion and the proximal end. The measurement portion includes distance indicia. The straight portion of the ruler of each surgical instrument has a longitudinal axis. The ruler of each surgical instrument is reciprocable in a proximal-distal direction with respect to the tube between a retracted position and an extended position. The measurement portion of the ruler of each surgical instrument extends in a different direction from the longitudinal axis of the straight portion when the ruler is in the extended position. [0018] In another aspect, the present invention provides a method of mapping a feature of a tissue site of a patient with a surgical instrument. The surgical instrument includes a tube and a ruler reciprocable with respect to the tube between a retracted position and an extended position. The ruler includes a distal end and distance indicia. The method comprises moving a portion of the tube to the tissue site with at least part of the ruler retracted. The tissue is pierced with a portion of the ruler at a selected fixation point to temporarily anchor the distal end of the ruler to the tissue at the fixation point. The tube is moved with respect to the ruler so that the ruler is in the extended position. A distance is determined based on the position of the tissue feature with respect to the fixation site. The tube is moved with respect to the ruler so that the ruler is in the retracted position and the tube and ruler are removed from the tissue site. [0019] In another aspect, the present invention comprises a method of measuring a feature of a tissue site within the body of a patient with a surgical instrument. The surgical instrument includes a tube having a proximal end and a distal end. An elongated member is reciprocable with respect to the tube between a distally retracted position and a distally extended position. The elongated member has a proximal end and a distal end, and distance indicia at its proximal end. The method comprises moving the distal end of the tube to the tissue site within the body of the patient and positioning the distal end of the elongated member at a first desired location. The tube is moved with respect to the elongated member so that the distal end of the tube is at a second desired location while the position of the distal end of the elongated member is maintained at the first desired location. The distance between the first desired location and the second desired location is determined by observing the distance indicia at the proximal end of the elongated member. [0020] In another aspect, the present invention comprises a method of mapping a feature of a tissue site of a patient with a surgical coordinate instrument and a surgical measuring instrument. The surgical coordinate instrument includes a tube and a coordinate ruler reciprocable with respect to the tube between a retracted position and an extended position. The coordinate ruler includes a distal end and distance indicia. The surgical measuring instrument includes a tube and a ruler reciprocable with respect to the tube between a retracted position and an extended position. The ruler includes a distal end and distance indicia. The method comprises moving a portion of the tube of the coordinate instrument to the tissue site with at least part of the coordinate ruler retracted. The tissue is pierced with a portion of the coordinate ruler at a selected fixation point to temporarily anchor the distal end of the coordinate ruler to the tissue at the fixation point. The tube is moved with respect to the coordinate ruler so that the coordinate ruler is in the extended position. A portion of the tube of the measuring instrument is moved to the tissue site with at least part of the ruler retracted. The distal end of the ruler is placed at a desired location related to the tissue feature to be mapped. The tube is moved with respect to the ruler until a portion of the measuring instrument crosses the coordinate ruler. The distance between the distal end of the ruler and the coordinate ruler is then determined. [0021] In another aspect the present invention comprises a surgical instrument having a proximal end and a distal end. The instrument comprises a handle, a tube and an elongated member. The tube extends distally from the handle, and defines a channel. A first gear is rotatably mounted to the handle, and has a plurality of grooved teeth. A second gear is rotatably mounted to the handle, and has a plurality of grooved teeth intermeshed with the grooved teeth of the first gear. The grooves of the intermeshed teeth of the first gear and second gear define a passageway aligned with the channel of the tube. The elongated member extends through the passageway and into the channel of the tube. The elongated member is movable in a proximal direction by rotating the first gear in one direction and is movable in the distal direction by rotating the first gear in the opposite direction. The elongated member has a distal end and includes distance indicia at the distal end. Continue reading about Coordinate instrument set... Full patent description for Coordinate instrument set Brief Patent Description - Full Patent Description - Patent Application Claims Click on the above for other options relating to this Coordinate instrument set patent application. ###  How KEYWORD MONITOR works... a FREE service from FreshPatents1. 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