Surgical instrument for removing an implanted object
Methods and devices for separating an implanted object, such as a pacemaker lead, from tissue surrounding such object in a patient's vasculature system. Specifically, the tissue separating device includes a handle, an elongate sheath and a circular cutting blade that may extend from the distal end of the sheath upon actuating the handle. The elongate sheath, particularly its distal end, includes a non-uniform wall thickness having one or more thicker portions in the outer sheath, particularly the outer cam member, and/or one or more thicker portions in an inner member disposed radially inward of the blade.
1. A device for removing an implanted object from a body vessel, the device comprising:
a handle;
a trigger movably coupled to the handle;
an elongated sheath extending from the handle, the elongated sheath comprising a lumen extending therethrough, wherein the lumen is configured to receive an implanted object, the elongated sheath further comprising a proximal portion and a distal portion;
a tubular outer member attached to the distal portion of the elongated sheath;
a pin attached to the tubular outer member and extending inwardly thereof;
a tubular inner member located within the tubular outer member, the tubular inner member comprising a proximal end, a distal end and an exterior surface therebetween, the distal end comprising a cutting surface, the exterior surface of the tubular inner member comprising a cam slot for receipt of and cooperation with the pin upon actuation of the trigger; and
a rotary actuator disposed within the handle, the rotary actuator comprising a linear-motion bearing coupled to the trigger, the linear-motion bearing surrounding a shaft, wherein the shaft is coupled to the tubular inner member, such that upon non-pivoting movement of the trigger relative to the handle, the tubular inner member rotates and the distal end of the tubular inner member translates axially and extends distally beyond the tubular outer member.
2. The device of claim 1 , wherein the linear-motion bearing comprises a nut and leadscrew assembly, wherein the leadscrew surrounds the shaft.
3. The device of claim 2 , wherein the shaft comprises an exterior surface, wherein at least a portion of the exterior surface is threaded, and wherein the nut comprises a threaded portion and the threaded portion of the exterior of the shaft matingly engages with the threaded portion of the nut.
4. The device of claim 1 , wherein the linear-motion bearing comprises a rolling ring bearing and an unthreaded shaft.
5. The device of claim 1 , wherein at least one portion of the tubular outer member has a non-uniform circumferential wall thickness.
6. The device of claim 5 , wherein the non-uniform circumferential wall thickness comprises a first segment and a second segment, wherein the first segment has a thickness greater than the second segment.
7. The device of claim 6 , wherein the first segment is disposed opposite the second segment along a cross section of a circumference of the tubular outer member.
8. The device of claim 6 , wherein the tubular outer member comprises an outer surface, and wherein the first segment transitions to the second segment without interruption on the outer surface.
9. The device of claim 6 , wherein at least one of the handle and the elongated sheath comprise an indicator indicative of a location of at least one of the first segment and the second segment.
10. The device of claim 5 , wherein the tubular outer member has a proximal end portion and a distal end portion, wherein the at least one portion of the tubular outer member having the non-uniform circumferential wall thickness is located at least at the distal end portion.
11. The device of claim 10 , wherein the at least one portion of the tubular outer member having the non-uniform circumferential wall thickness comprises a first segment having a thickness greater than a second segment.
12. The device of claim 10 , wherein the at least one portion of the tubular outer member having the non-uniform circumferential wall thickness comprises a first segment, a second segment, and a third segment, wherein the first segment and the second segment have a thickness greater than the third segment.
13. The device of claim 12 , further comprising a third tubular member located within the tubular inner member, wherein at least one portion of the third tubular member has a non-uniform circumferential wall thickness.
14. The device of claim 13 , wherein the non-uniform circumferential wall thickness of the third tubular member comprises a first segment and a second segment, wherein the first segment has a thickness greater than the second segment.
15. The device of claim 1 , wherein the tubular inner member is a first tubular inner member, and further comprising a second tubular inner member, wherein at least one portion of the second tubular inner member has a non-uniform circumferential wall thickness.
16. The device of claim 15 , wherein the non-uniform circumferential wall thickness comprises a first segment and a second segment, wherein the first segment has a thickness greater than the second segment.
17. The device of claim 16 , wherein the first segment is disposed opposite the second segment along a cross section of a circumference of the second tubular inner member.
18. A device for removing an implanted object from a body vessel, the device comprising:
a handle;
a trigger movably coupled to the handle;
an elongated sheath extending from the handle, the elongated sheath comprising a lumen extending therethrough, wherein the lumen is configured to receive an implanted object, the elongated sheath further comprising a proximal portion and a distal portion;
a tubular outer member attached to the distal portion of the elongated sheath;
a pin attached to the tubular outer member and extending inwardly thereof;
a tubular inner member located within the tubular outer member, the tubular inner member comprising a proximal end, a distal end and an exterior surface therebetween, the distal end comprising a cutting surface, the exterior surface of the tubular inner member comprising a cam slot for receipt of and cooperation with the pin upon actuation of the trigger; and
a linear-motion bearing coupled to the trigger and the tubular inner member, such that upon actuating the trigger solely in a linear direction, the tubular inner member rotates and translates axially and extends distally beyond or retracts into the tubular outer member.