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Tissue remover and methodRelated Patent Categories: Surgery, Instruments, Light Application, ApplicatorsTissue remover and method description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20050283143, Tissue remover and method. Brief Patent Description - Full Patent Description - Patent Application Claims
CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims the benefit of U.S. Provisional Application No. 60/535,182, filed Jan. 8, 2004 and entitled TISSUE REMOVE AND METHOD, the contents of which are expressly incorporated herein by reference. This application is a continuation-in-part of co-pending U.S. application Ser. No. 10/667,921 filed Sep. 22, 2003 and entitled TISSUE REMOVER AND METHOD, which is a continuation of co-pending U.S. application Ser. No. 09/714,479 filed Nov. 15, 2000 and entitled TISSUE REMOVER AND METHOD, which is a continuation-in-part of U.S. application Ser. No. 09/188,072, filed Nov. 6, 1998, now U.S. Pat. No. 6,254,597 and entitled TISSUE REMOVER AND METHOD, the contents of all of the above which are expressly incorporated herein by reference. U.S. application Ser. No. 09/188,072 claims the benefit of U.S. Provisional Application No. 60/064,465 filed Nov. 6, 1997 and entitled ELECTROMAGNETICALLY INDUCED MECHANICAL CUTTER FOR LYPOSUCTION the contents of which are expressly incorporated herein by reference. U.S. application Ser. No. 09/188,072 is also a continuation-in-part of U.S. application Ser. No. 08/985,513 filed Dec. 5, 1997 and entitled USER PROGRAMMABLE COMBINATION OF ATOMIZED PARTICLES FOR ELECTROMAGNETICALLY INDUCED CUTTING, which is a continuation of U.S. application Ser. No. 08/522,503 filed Aug. 31, 1995 and entitled USER PROGRAMMABLE COMBINATION OF ATOMIZED PARTICLES FOR ELECTROMAGNETICALLY INDUCED CUTTING which issued into U.S. Pat. No. 5,741,247, both of which are commonly assigned and the contents of which are expressly incorporated herein by reference. U.S. application Ser. No. 09/188,072 is also a continuation-in-part of co-pending U.S. application Ser. No. 08/995,241, filed Dec. 17, 1997 and entitled FLUID CONDITIONING SYSTEM, which is a continuation of U.S. application Ser. No. 08/575,775, filed Dec. 20, 1995 and entitled FLUID CONDITIONING SYSTEM which issued into U.S. Pat. No. 5,785,521, both of which are commonly assigned and the contents of which are expressly incorporated herein by reference. BACKGROUND OF THE INVENTION [0002] 1. Field of the Invention [0003] The present invention relates generally to medical apparatus and, more particularly, to methods and apparatus for cutting and removing soft or hard tissue from patients. [0004] 2. Description of Related Art [0005] Turning to FIG. 1, an example of one of many varying types of prior art optical cutters includes a fiber guide tube 5, a water line 7, an air line 9, and an air knife line 11 for supplying pressurized air. A cap 15 fits onto the hand-held apparatus 13 and is secured via threads 17. The fiber guide tube 5 abuts within a cylindrical metal piece 19. Another cylindrical metal piece 21 is a part of the cap 15. The pressurized air from the air knife line 11 surrounds and cools the laser as the laser bridges the gap between the two metal cylindrical objects 19 and 21. Air from the air knife line 11 flows out of the two exhausts 25 and 27 after cooling the interface between elements 19 and 21. [0006] The laser energy exits from the fiber guide tube 23 and is applied to a target surface of the patient. Water from the water line 7 and pressurized air from the air line 9 are forced into the mixing chamber 29. The air and water mixture is very turbulent in the mixing chamber 29, and exits this chamber through a mesh screen with small holes 31. The air and water mixture travels along the outside of the fiber guide tube 23, and then leaves the tube and contacts the area of surgery. [0007] Other examples of a wide array of prior art devices and methods include U.S. Pat. No. 5,199,870 to Steiner et al. and U.S. Pat. No. 5,267,856 to Wolbarsht et al. Other devices have existed in the prior art for utilizing laser energy to perform soft tissue procedures, wherein for example laser energy facilitates the separation or manipulation of soft tissue in vivo. U.S. Pat. No. 4,985,027 to Dressel discloses one example of many various types of devices in the field. According to this one example of a prior art device, the contents of which are expressly incorporated herein by reference, a tissue remover utilizes laser energy from a Nd:YAG to separate tissue held within a cannula. Use of the Nd:YAG laser for in vivo tissue removal may in some ways be inefficient, since the energy from the Nd:YAG laser may not be highly absorbed by water. Further, the Nd:YAG laser and other lasers, such as an Er:YAG laser, may in some configurations use thermal heating as the sole cutting mechanism. Adjacent tissue may in certain implementations be charred or thermally damaged and, further, noxious and potentially toxic smoke may in some instances be generated during the thermal cutting operations. [0008] Many devices also have existed in the prior art for performing endoscopic surgical procedures, wherein for example one or more catheters or cannulas are inserted through a small opening in a patient's skin to provide various working passageways through which small surgical instruments can be advanced into the patient during surgery. Specific endoscopic applications include arthroscopic surgery, neuroendoscopic surgery, laparoscopic surgery, and liposuction. Arthroscopic surgery refers to surgery related to, for example, joints such as the shoulders and knees. One example of a prior-art device, which has been used during the implementation of an arthroscopic surgical procedure, is an arthroscopic shaver. The arthroscopic shaver entails the application of a spinning tube-within-a-tube that concurrently resects tissue while aspirating debris and saline from within the operative site. One such arthroscopy system is the DYONICS.RTM. Model EP-1 available from Smith & Nephew Endoscopy, Inc., of Andover, Mass. Cutting with such an instrument is obtained by driving the inner tube at a high speed using a motor. Surrounding the tubular blade is an outer tubular membrane having a hub at its proximal end adapted to meet with the handle. Performing an arthroscopic procedure with a high-speed rotary shaver such as the one mentioned may in certain instances result in extensive trauma to the tissue and blood vessel laceration. SUMMARY OF THE INVENTION [0009] The present invention discloses an electromagnetically induced cutting mechanism, which can provide accurate cutting operations on hard and soft tissues, and other materials as well. Soft tissues may include fat skin, mucosa, gingiva, muscle, heart, liver, kidney, brain, eye, and vessels, and hard tissue may include tooth enamel, tooth dentin, tooth cementum, tooth decay, amalgam, composites materials, tarter and calculus, bone and cartilage. [0010] In accordance with the present invention, an electromagnetically induced cutter is used to perform surgical procedures, using cannulas and catheters, also known as endoscopic surgical procedures. Endoscopic surgical applications for the electromagnetic cutter of the present invention include arthroscopic surgery, neuroendoscopic surgery, laparoscopic surgery, liposuction and other endoscopic surgical procedures. The electromagnetically induced cutter is suitable to be used for arthroscopic surgical procedures in the treatment of, for example: (i) torn menisci, anterior cruciate, posterior cruciate, patella malalignment, synovial diseases, loose bodies, osteal defects, osteophytes, and damaged articular cartilage (chondromalacia) of the knee; (ii) synovial disorders, labial tears, loose bodies, rotator cuff tears, anterior impingement and degenerative joint disease of the acromioclavicular joint and diseased articular cartilage of the shoulder joint; (iii) synovial disorders, loose bodies, osteophytes, and diseased articular cartilage of the elbow joint; (iv) synovial disorder, loose bodies, ligament tears and diseased articular cartilage of the wrist; (v) synovial disorders, loose bodies, labrum tears and diseased articular cartilage in the hip; and (vi) synovial disorders, loose bodies, osteophytes, fractures, and diseased articular cartilage in the ankle. [0011] The electromagnetically induced cutter of the present invention is disposed within a carnula or catheter and positioned therein near the surgical site where the treatment is to be performed. In accordance with one aspect of the present invention, a diameter of the cannula or catheter is minimized to reduce the overall cross-sectional area of the cannula or catheter for the performance of minimally invasive procedures. In accordance with another aspect of the present invention, a plurality of catheters may be formed together for various purposes. For example, in arthroscopic knee surgery, one cannula can be configured to incorporate the cutting device and suction, and a separate cannula can be configured to incorporate the imaging system that monitors the treatment site during the procedure. In accordance with yet another aspect of the present invention, the suction, cutting device and imaging device may all be incorporated within the same cannula. Another aspect of the present invention may provide for an additional third cannula for supplying air to the treatment site. [0012] The electromagnetically induced cutter of the present invention may be capable of providing extremely fine and smooth incisions, irrespective of the cutting surface. Additionally, a user programmable combination of atomized particles may allow for user control of various cutting parameters. The various cutting parameters may also be controlled by changing spray nozzles and electromagnetic energy source parameters. Applications for the present invention include medical procedures, such as arthroscopic surgery, neuroendoscopic surgery, laparoscopic surgery, liposuction and dental, and other environments where an objective may be to precisely remove surface materials with attenuation or elimination or one or more of thermal damage, uncontrolled cutting parameters, and/or rough surfaces inappropriate for ideal bonding. Certain implementations of the present invention further may not require films of water or particularly porous surfaces to obtain accurate and controlled cutting. Since in certain embodiments thermal heating may not be used, or may not be used exclusively, as the cutting mechanism, thermal damage may be attenuated or substantially eliminated. Moreover, in certain implementations, adjacent tissue may not be charred or thermally damaged, or charred or thermally damaged less, and, further, noxious and potentially toxic smoke may be attenuated or completely eliminated. [0013] The electromagnetically induced cutter of the present invention includes an electromagnetic energy source, which focuses electromagnetic energy into a volume of air adjacent to a target surface. The target surface may comprise tissue within a cannula, for example. A user input device specifies a type of cut to be performed, and an atomizer responsive to the user input device places a combination of atomized fluid particles into the volume of air. The electromagnetic energy is focused into the volume of air, and the wavelength of the electromagnetic energy is selected to be substantially absorbed by the atomized fluid particles in the volume of air. Upon absorption of the electromagnetic energy the atomized fluid particles expand and impart cutting forces onto the target surface. [0014] The electromagnetically induced cutter of the present invention can provide an improvement over prior-art high-speed rotary shavers, such as the above-mentioned arthroscopic shaver, since the electromagnetically induced cutter of the present invention may not directly contact the tissue to cause trauma and blood vessel laceration. Instead, cutting forces may remove small portions of the tissue through a process of fine or gross erosion depending on the precision required. This process can be applied to precisely and cleanly shave, reshape, cut through or remove, for example, cartilage, fibrous cartilage, or bone without the heat, vibration, and pressure associated with rotary shaving instruments. The system can be used without air and/or water, in order to coagulate bleeding tissue. In accordance with another application of the electromagnetic cutter, a spray of water can be the carrier of an anti-coagulant medication that may also contribute to tissue coagulation. [0015] Other endoscopic applications for the electromagnetically induced cutter may include neurosurgical and abdominal surgical applications. In neurosurgery, the electromagnetically induced cutter may be suited for removing brain tissue lesions, as well as for the cutting of various layers of tissue to reach the locations of the lesions. The entire method of creating an access through the scalp into the bone and through the various layers of tissue that protect the brain tissue may be accomplished with the electromagnetically induced cutter of the present invention. [0016] The invention, together with additional features and advantages thereof may best be understood by reference to the following description taken in connection with the accompanying illustrative drawings. BRIEF DESCRIPTION OF THE DRAWINGS [0017] FIG. 1 is an example of one of many types of conventional optical cutter apparatuses; [0018] FIG. 2 is a schematic block diagram illustrating an example of an electromagnetically induced cutter of the present invention; [0019] FIG. 3 illustrates an example of one embodiment of the electromagnetically induced cutter of the present invention; [0020] FIGS. 4a and 4b illustrate examples of other embodiments of electromagnetically induced cutters; Continue reading about Tissue remover and method... 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