Tissue remover and method

Abstract

An electromagnetically induced cutting mechanism provides accurate cutting operations on hard or soft tissues. The electromagnetically induced cutter is adapted to interact with atomized fluid particles. A tissue remover comprises an aspiration cannula housing a fluid and energy guide for conducting electromagnetically induced cutting forces to the site within a patient's body for aspiration of hard or soft tissue. The cannula is provided with a cannula distal end. The proximal end of the cannula is provided with fluid flow connection to an aspiration source. Separated hard or soft tissue and fluid are aspirated through the cannula distal end and the cannula by an aspiration source at the proximal end of the cannula. Methods of using such a cutter for hard or soft tissue removal are also disclosed.

1 . A method for removing hard tissue from a patient comprising: 
 providing a tissue remover having a proximal end and a distal end, and a fluid guide and an energy guide extending from the proximal end towards the distal end;    inserting the tissue remover through an incision in the patient so that the distal end of the tissue remover is in proximity to hard tissue;    transmitting gas and fluid through the fluid guide of the tissue remover;    generating atomized fluid particles in an interaction zone located in close proximity to the distal end of the tissue remover by using the air and fluid transmitted through the fluid and energy guide;    providing electromagnetic energy from an energy source to an electromagnetic energy transmitter operatively mounted within the fluid and energy guide; and    transmitting the electromagnetic energy from an output end of the energy transmitter into the interaction zone, the electromagnetic energy having a wavelength which is substantially absorbed by a portion of atomized fluid particles in the interaction zone, the absorption of the electromagnetic energy by the portion of atomized fluid particles causing the portion of atomized fluid particles to expand and impart disruptive cutting forces onto the tissue in close proximity to the distal end of the tissue remover.    
     
     
         2 . The method of  claim 1 , further comprising a step of aspirating the hard tissue removed by the tissue remover.  
     
     
         3 . The method of  claim 1 , wherein the hard tissue is removed by eroding the hard tissue with the forces generated by the electromagnetic energy and the atomized fluid particles.  
     
     
         4 . The method of  claim 1 , wherein the hard tissue comprises bone.  
     
     
         5 . The method of  claim 1 , wherein the hard tissue is removed in an arthroscopic procedure of the patient's knee.  
     
     
         6 . The method of  claim 1 , wherein the hard tissue is removed without inducing thermal damage to the surrounding tissue.  
     
     
         7 . The method of  claim 1 , wherein the energy source comprises an erbium, chromium, yttrium, scandium, gallium garnet (Er, Cr:YSGG) solid state laser.  
     
     
         8 . The method of  claim 1 , wherein the energy source comprises a CO 2  laser.  
     
     
         9 . The method of  claim 1 , wherein the fluid comprises water.  
     
     
         10 . The method of  claim 1 , wherein the fluid comprises an anesthetic.  
     
     
         11 . The method of  claim 1 , wherein the fluid comprises a saline solution.  
     
     
         12 . The method of  claim 1 , wherein the fluid comprises epinephrine.  
     
     
         13 . A system for removing hard tissue from a knee of a patient, comprising: 
 a tissue remover disposed in a cannula having a proximal end and a distal end that is structured to be inserted into a patient's knee joint, the tissue remover having a fluid guide and an energy guide extending towards the distal end of the cannula, wherein the fluid guide is structured to guide fluid and gas toward the distal end of the cannula to create atomized fluid particles; and    an energy source to provide electromagnetic energy through the energy guide to an energy transmitter that transmits the electromagnetic energy to an interaction zone located in close proximity to the distal end of the cannula where the electromagnetic energy is absorbed by atomized fluid particles in the interaction zone to impart erosive forces to cause removal of hard tissue from the patient's knee.    
     
     
         14 . The system of  claim 13  further comprising an aspirator attached to the cannula to aspirate hard tissue removed by the tissue cutter.  
     
     
         15 . The system of  claim 14 , wherein the aspirator is disposed in a lumen of the cannula to cause the hard tissue to be aspirated through the cannula.  
     
     
         16 . The system of  claim 13 , wherein the fluid guide and energy transmitter are positioned so that the interaction zone is in proximity to the hard tissue to be removed from the knee without inducing thermal damage to the surrounding knee tissue.  
     
     
         17 . The system of  claim 13 , wherein the energy source comprises an erbium, chromium, yttrium, scandium, gallium garnet (Er, Cr:YSGG) solid state laser.  
     
     
         18 . The system of  claim 13 , wherein the energy source comprises a CO 2  laser.  
     
     
         19 . The system of  claim 13 , wherein the cannula is formed of a medical grade plastic.  
     
     
         20 . The system of  claim 13 , wherein the cannula is formed of a stainless steel.  
     
     
         21 . The system of  claim 13 , wherein the energy transmitter is a fiber optic delivery system.  
     
     
         22 . The system of  claim 13 , wherein the fluid comprises water.  
     
     
         23 . The system of  claim 13 , wherein the fluid comprises an anesthetic.  
     
     
         24 . The system of  claim 13 , wherein the fluid comprises a saline solution.  
     
     
         25 . The system of  claim 13 , wherein the fluid comprises epinephrine.  
     
     
         26 . The system of  claim 13 , wherein the energy source comprises an ER:YAG laser.  
     
     
         27 . The system of  claim 13 , wherein the fluid comprises epinephrine and an anesthetic.  
     
     
         28 . The system of  claim 13 , further comprising a camera attached to the cannula to provide images of the knee joint to a user of the system.  
     
     
         29 . A method for removing hard tissue from a knee of a patient comprising: 
 providing a tissue remover having a proximal end and a distal end, and a fluid and energy guide extending from the proximal end towards the distal end;    inserting the tissue remover through an incision so that the distal end of the tissue remover is in proximity to the patient's femur;    transmitting gas and fluid through the fluid guide of the tissue remover;    generating atomized fluid particles in an interaction zone located in close proximity to the distal end of the tissue remover by using the air and fluid transmitted through the fluid and energy guide;    providing electromagnetic energy from an energy source to an electromagnetic energy transmitter operatively mounted within the fluid and energy guide;    transmitting the electromagnetic energy from an output end of the energy transmitter into the interaction zone, the electromagnetic energy having a wavelength which is substantially absorbed by a portion of atomized fluid particles in the interaction zone, the absorption of the electromagnetic energy by the portion of atomized fluid particles causing the portion of atomized fluid particles to expand and impart disruptive cutting forces that erode the patient's femur to expose a surface of the patient's tibia;    removing a portion of the meniscus overlying the surface of the tibia by transmitting the electromagnetic energy to the energy transmitter to create cutting forces to erode the patient's meniscus; and    removing a portion of the patient's tibia to create a receptacle for a prosthetic implant.    
     
     
         30 . The method of  claim 29 , further comprising a step of removing damaged tissue from the patient's femur to create an opening for a femoral prosthetic implant.  
     
     
         31 . The method of  claim 29 , further comprising a step of applying an adhesive to the receptacle in the tibia to provide adhesion of the prosthetic implant to the tibia.  
     
     
         32 . The method of  claim 28 , further comprising a step of applying adhesive to the receptacle in the tibia and the opening in the femur to provide adhesion of the prosthetic implants and the bones.  
     
     
         33 . The method of  claim 32 , further comprising a step of securing prosthetic implants to the adhesive disposed in the femur and the tibia of the patient.  
     
     
         34 . The method of  claim 27 , wherein the tissue is removed by scanning the distal end of the tissue remover along the surface of the tissue without directly contacting the tissue.  
     
     
         35 . The method of  claim 27 , wherein the method is performed for knee replacement surgery.