Device and method for ultrasonic tissue excision with tissue selectivity

Abstract

A surgical method utilizes a cutting blade having a thickness along a cutting edge of between about 0.0005 inch and about 0.020 inch and preferably between about 0.001 inch and 0.010 inch. The blade is moved in contact with relatively hardly tissues which are disposed adjacent to softer tissues at a surgical site in a patient. The blade is ultrasonically vibrated during the moving of the blade, whereby the hard tissue is cut with a modicum of damage being inflicted on the soft tissue.

What is claimed is:  
     
         1 . An ultrasonic surgical blade comprising a generally flat blade having a thickness along a cutting edge of between about 0.0005 inch and about 0.020 inch.  
     
     
         2 . The surgical blade defined in  claim 1  wherein said thickness is an edge thickness, said blade having a flat body portion with a body thickness greater than said edge thickness, said blade including a beveled or tapered region extending from said body portion to said edge.  
     
     
         3 . The surgical blade defined in  claim 2  wherein said cutting edge is disposed in a single plane and has an arcuate section.  
     
     
         4 . The surgical blade defined in  claim 3  wherein said cutting edge includes a pair of straight sections continuous with said arcuate section at opposite ends thereof.  
     
     
         5 . The surgical blade defined in  claim 4  wherein said blade is provided with a shank having an axially extending bore for the conveyance of cooling fluid to said cutting edge, said blade body being provided with an axially extending through-slot communicating at one end with said bore.  
     
     
         6 . The surgical blade defined in  claim 1  wherein the thickness of said cutting edge is between about 0.001 inch and about 0.010 inch.  
     
     
         7 . The surgical blade defined in  claim 6  wherein the thickness of said cutting edge is between about 0.001 inch and about 0.003 inch.  
     
     
         8 . A surgical method comprising: 
 providing a cutting blade having a thickness along a cutting edge of between about 0.0005 inch and about 0.020 inch;    moving said blade in contact with relatively hard tissue located adjacent to relatively soft tissue at a surgical site in a patient, so that said cutting edge cuts through said hard tissue and leaves said soft tissue substantially intact and undamaged; and    ultrasonically vibrating said blade during the moving of said blade.    
     
     
         9 . The method defined in  claim 8  wherein the vibrating of said blade is initiated prior to a contacting of said surgical site with said blade and is maintained during an initial contact of said blade with the tissues at said surgical site and during the moving of said blade through said hard tissue.  
     
     
         10 . The method defined in  claim 9  wherein said blade is moved in a continuous and uninterrupted stroke along said interface, the ultrasonic vibrating of said blade being performed continuously and uninterruptedly during said stroke.  
     
     
         11 . The method defined in  claim 3 , further comprising terminating the ultrasonic vibrating of said blade and removing said blade from the surgical site upon the completion of said stroke.  
     
     
         12 . The method defined in  claim 4 , further comprising introducing irrigation fluid to said surgical site during the moving of said blade along said interface.  
     
     
         13 . The method defined in  claim 8  wherein said blade is moved in a continuous and uninterrupted stroke along an interface between said hard tissue and said soft tissue, the ultrasonic vibrating of said blade being performed continuously and uninterruptedly during said stroke.  
     
     
         14 . The method defined in  claim 13 , further comprising terminating the ultrasonic vibrating of said blade and removing said blade from the surgical site after the moving of said blade along said interface.  
     
     
         15 . The method defined in  claim 8 , further comprising introducing irrigation fluid to said surgical site during the moving of said blade.  
     
     
         16 . The method defined in  claim 8  wherein the thickness of said cutting edge is between about 0.001 inch and about 0.010 inch.  
     
     
         17 . A surgical method comprising: 
 providing a cutting blade having a thickness along a cutting edge of between about 0.001 inch and about 0.010 inch;    moving said blade in a surgical site in a patient so that said cutting edge moves generally along an interface between relatively hard tissue and relatively soft tissue; and    ultrasonically vibrating said blade during the moving of said blade along said interface, whereby said hard tissue is cut and separated from said soft tissue with a modicum of damage being inflicted on said soft tissue.