Laparoscopic device
A medical instrument includes a tubular cutter extending along an axis and having a windowed outer sleeve and a moveable inner cutting sleeve. An ultrasound transducer is operatively coupled to the inner cutting sleeve in order to induce motion in the inner cutting sleeve to enhance cutting or resection of tissue by the inner cutting sleeve as it is reciprocated or otherwise moved past the cutting window. The instrument typically will include a motor drive configured to reciprocate and/or rotate the inner cutting sleeve relative to the windowed outer sleeve, usually at a reciprocation rate between 1 and 10 Hz.
1. A tubular cutter comprising:
an outer sleeve having a lumen disposed along an axis;
an inner cutting sleeve mounted in the lumen of the outer sleeve;
a first vibratory driver operatively coupled to the inner cutting sleeve and configured to longitudinally oscillate the inner cutting sleeve in the outer sleeve;
at least a second vibratory driver operatively coupled to the inner cutting sleeve and configured to rotationally oscillate the inner cutting sleeve in the outer sleeve;
wherein a cutting edge on the inner cutting sleeve is configured to engage tissue to cut tissue while the first and second vibratory drivers are operating.
2. The tubular cutter of claim 1 , wherein the outer sleeve has a cutting window and the cutting edge on the inner sleeve is disposed through the cutting window.
3. The tubular cutter of claim 2 , further comprising a motor drive configured to reciprocate the inner cutting sleeve relative to the cutting window.
4. The tubular cutter of claim 3 , wherein the motor drive reciprocates the inner cutting sleeve at a reciprocation rate between 1 and 10 Hz.
5. The tubular cutter of claim 1 , the first and second vibratory drivers comprise ultrasound transducers.
6. The tubular cutter of claim 5 , wherein a dimension between the ultrasound transducer and the distal end of the inner sleeve is selected to optimize at least one of axial motion and rotational motion in the distal end of the inner cutting sleeve.
7. The tubular cutter of claim 1 , wherein the ultrasound transducer is removably secured to a handle portion of the tubular cutter.
8. The tubular cutter of claim 7 , further comprising a controller for controlling operating parameters of the vibratory drivers, the motor drive, the negative pressure source and the pressurized fluid source.
9. The tubular cutter of claim 8 , further comprising a sensor configured to send signals to the controller indicating the position of the inner sleeve relative to a cutting window in the outer sleeve.
10. The tubular cutter of claim 9 , wherein the controller is adapted to modulate activation of the vibratory drivers in response to the sensor signals that indicate the position of the inner sleeve.
11. The tubular cutter of claim 10 , wherein the controller activates the vibratory drivers when the inner sleeve moves toward a tissue-cutting position to cut tissue and de-activates the vibratory drivers when the inner sleeve moves toward a non-cutting position.
12. The tubular cutter of claim 1 , further comprising a negative pressure source coupled to a tissue extraction lumen in the tubular cutter.
13. The tubular cutter of claim 12 , further comprising a pressurized fluid source coupled to an inflow lumen in the cutter.
14. The tubular cutter of claim 13 , wherein the inflow lumen extends to an outlet in a distal portion of the cutter.
15. The tubular cutter of claim 13 , wherein the pressurized fluid source comprises a liquid source.
16. The tubular cutter of claim 13 , wherein the pressurized fluid source comprises a gas source.