Concentric cutting devices for use in minimally invasive medical procedures

Abstract

Various embodiments of a tissue cutting device are described, such as a device with an elongate tube having a proximal end and a distal end and a central axis extending from the proximal end to the distal end; a first annular element at the distal end of the elongate tube, the first annular element having a flat portion at its distal end perpendicular to the central axis, the flat portion extending from an outer circumference of the first annular element to the central axis; and a second annular element at the distal end of the elongate tube and concentric with the first annular element, the second annular element having a flat portion at its distal end perpendicular to the central axis, at least one of the first or second annular elements rotatable about the central axis, the rotation causing the first annular element and the second annular element to pass each other to shear tissue.

1 . A tissue cutting device comprising:
 an elongate tube having a proximal end and a distal end and a central axis extending from the proximal end to the distal end;   a first annular element at the distal end of the elongate tube, the first annular element having a flat portion at its distal end perpendicular to the central axis, the flat portion extending from an outer circumference of the first annular element to the central axis; and   a second annular element at the distal end of the elongate tube and concentric with the first annular element, the second annular element having a flat portion at its distal end perpendicular to the central axis, at least one of the first or second annular elements rotatable about the central axis, the rotation causing the first annular element and the second annular element to pass each other to shear tissue.   
     
     
         2 . The tissue cutting device of  claim 1  wherein the elongate tube has a diameter less than 5 mm. 
     
     
         3 . The tissue cutting device of  claim 1  wherein at least one of the first and second annular elements has a tooth having a radial thickness of less than 50 microns. 
     
     
         4 . The tissue cutting device of  claim 1 , wherein the flat portion has an axial thickness of less than 100 microns. 
     
     
         5 . The tissue cutting device of  claim 1  wherein the first annular element is rotatable about the central axis in an opposite direction from the second annular element. 
     
     
         6 . The tissue cutting device of  claim 1  wherein the first annular element is rotatable about the central axis in a same direction as the second annular element, the first annular element and the second annular element being configured to be rotated at different speeds. 
     
     
         7 . The tissue cutting device of  claim 1 , further comprising an intake window at the distal end of the elongate tube. 
     
     
         8 . The tissue cutting device of  claim 1 , further comprising a hole extending along the central axis. 
     
     
         9 . The tissue cutting device of  claim 8 , further comprising an ancillary component extending through the hole, the ancillary component comprising an imaging element, a guide wire, a water jet tube, or a barbed device. 
     
     
         10 . The tissue cutting device of  claim 1 , further comprising a third annular element and a fourth annular element, the third and fourth annular elements located between the proximal and distal ends, at least one of the third or fourth annular elements configured to rotate, the rotation causing the third and fourth annular elements to rotate past each other to further shear the tissue. 
     
     
         11 . A tissue cutting device comprising:
 an elongate tube having a proximal end and a distal end and a central axis extending from the proximal end to the distal end;   a first annular element at the distal end of the elongate tube;   a second annular element at the distal end of the elongate tube and concentric with the first annular element, at least one of the first or second annular elements rotatable about the central axis, the rotation causing the first annular element and the second annular element to pass each other to shear tissue;   wherein the first and second elements together form a conical shape at the distal end of the elongate tube;   and wherein edges of the first and second tubular element are beveled to further shear tissue.   
     
     
         12 . The tissue cutting device of  claim 11  wherein the elongate tube has a diameter less than 5 mm. 
     
     
         13 . The tissue cutting device of  claim 11  wherein the beveled edges have a thickness less than 10 microns. 
     
     
         14 . The tissue cutting device of  claim 11  wherein the first annular element is rotatable about the central axis in an opposite direction from the second annular element. 
     
     
         15 . The tissue cutting device of  claim 11  wherein the first and second elements together form a second conical shape, the second conical shape facing proximally. 
     
     
         16 . The tissue cutting device of  claim 11  wherein the first annular element is rotatable about the central axis in a same direction as the second annular element, the first annular element and the second annular element being configured to rotate at different speeds. 
     
     
         17 . The tissue cutting device of  claim 11 , further comprising an intake window at the distal end of the elongate tube. 
     
     
         18 . The tissue cutting device of  claim 11 , further comprising a hole extending along the central axis. 
     
     
         19 . The tissue cutting device of  claim 18 , further comprising an ancillary component extending through the hole, the ancillary component comprising an imaging element, a guide wire, a water jet tube, or a barbed device. 
     
     
         20 . The tissue cutting device of  claim 11 , further comprising a third annular element and a fourth annular element, the third and fourth annular elements located between the proximal and distal ends, at least one of the third or fourth annular elements configured to rotate, the rotation causing the third and fourth annular elements to rotate past each other to further shear the tissue. 
     
     
         21 . A tissue cutting device comprising:
 an elongate tube having a proximal end and a distal end and a central axis extending from the proximal end to the distal end;   a first annular element at the distal end of the elongate tube;   a second annular element at the distal end of the elongate tube and concentric with the first annular element, at least one of the first or second annular elements rotatable about the central axis;   wherein the first and second annular elements each have an axially-extending cutting surface, the rotation causing the axially-extending surfaces of the first and second annular elements to pass each other to shear tissue, and wherein the first and second annular elements each have a radially-extending cutting surface, rotation causing the axially-extending surfaces of the first and second elements to pass each other to shear tissue, wherein the axially extending cutting surface has an axial length of less than 100 microns.   
     
     
         22 . The tissue cutting device of  claim 21  further comprising teeth extending along the axially-extending or radially-extending cutting surfaces. 
     
     
         23 . The tissue cutting device of  claim 21  wherein the elongate tube has a diameter less than 0.5 mm. 
     
     
         24 . The tissue cutting device of  claim 21  wherein the first annular element is rotatable about the central axis in an opposite direction from the second annular element. 
     
     
         25 . The tissue cutting device of  claim 21  wherein the first annular element is rotatable about the central axis in a same direction as the second annular element, the first annular element and the second annular element being configured to be rotated at different speeds. 
     
     
         26 . The tissue cutting device of  claim 21 , further comprising an intake window at the distal end of the elongate tube. 
     
     
         27 . The tissue cutting device of  claim 21  further comprising a hole extending along the central axis. 
     
     
         28 . The tissue cutting device of  claim 27 , further comprising an ancillary component extending through the hole, the ancillary component comprising an imaging element, a guide wire, a water jet tube, or a barbed device. 
     
     
         29 . The tissue cutting device of  claim 21 , further comprising a third annular element and a fourth annular element, the third and fourth annular elements located between the proximal and distal ends, at least one of the third or fourth annular elements configured to rotate, the rotation causing the third and fourth annular elements to rotate past each other to further shear the tissue. 
     
     
         30 . A tissue cutting device comprising:
 an elongate tube having a proximal end and a distal end and a central axis extending from the proximal end to the distal end;   a first annular element at the distal end of the elongate tube;   a second annular element at the distal end of the elongate tube and concentric with the first annular element, at least one of the first or second annular elements rotatable about the central axis;   wherein the first and second annular elements each include axially-extending teeth, the teeth having a radial thickness of less than 10 microns, the rotation causing the teeth of the first annular element and the teeth of the second annular element to pass each other to shear tissue.   
     
     
         31 . The tissue cutting device of  claim 30 , wherein the elongate tube has a diameter less than 5 mm. 
     
     
         32 . The tissue cutting device of  claim 30  wherein the first annular element is rotatable about the central axis in an opposite direction from the second annular element. 
     
     
         33 . The tissue cutting device of  claim 30  wherein the first annular element is rotatable about the central axis in a same direction as the second annular element, the first annular element and the second annular element being configured to be rotated at different speeds. 
     
     
         34 . The tissue cutting device of  claim 30  wherein the teeth have a pitch of less than 200 microns. 
     
     
         35 . The tissue cutting device of  claim 30 , further comprising an intake window at the distal end of the elongate tube. 
     
     
         36 . The tissue cutting device of  claim 30 , further comprising a hole extending along the central axis. 
     
     
         37 . The tissue cutting device of  claim 36 , further comprising an ancillary component extending through the hole, the ancillary component comprising an imaging element, a guide wire, a water jet tube, or a barbed device. 
     
     
         38 . The tissue cutting device of  claim 30 , further comprising a third annular element and a fourth annular element, the third and fourth annular elements located between the proximal and distal ends, at least one of the third or fourth annular elements configured to rotate, the rotation causing the third and fourth annular elements to rotate past each other to further shear the tissue. 
     
     
         39 . A tissue cutting device, comprising:
 an elongate tube having a proximal end and a distal end and a central axis extending from the proximal end to the distal end;   a first annular element at the distal end of the elongate tube, the first annular element including a plurality of first shearing elements, each first shearing element having a perpendicular shearing surface that is perpendicular to the central axis;   a second annular element at the distal end of the elongate tube and concentric with the first annular element, the second annular element including a plurality of second shearing elements, each second shearing element having a perpendicular shearing surface that is perpendicular to the central axis,   wherein at least one of the first or second annular elements is rotatable about the central axis, the rotation causing the perpendicular shearing surfaces of the first shearing elements and the perpendicular shearing surfaces of the second shearing elements to pass each other to shear tissue.   
     
     
         40 . The tissue cutting device of  claim 39 , wherein at least some of the perpendicular shearing surfaces of the first shearing elements lie along the same plane. 
     
     
         41 . The tissue cutting device of  claim 40 , wherein the at least some of the perpendicular shearing surfaces are located at the same radial distance from the central axis. 
     
     
         42 . The tissue cutting device of  claim 39 , wherein at least some of the perpendicular shearing surfaces do not lie along the same plane. 
     
     
         43 . The tissue cutting device of  claim 42 , wherein the at least some perpendicular shearing surfaces are located at different radial distances from the central axis. 
     
     
         44 . The tissue cutting device of  claim 39 , wherein each first shearing element has a parallel shearing surface that is parallel to the central axis;
 wherein each second shearing element has a parallel shearing surface that is parallel to the central axis; and   wherein rotation of one or both of the first and second annular element the causes the parallel shearing surfaces of the first shearing elements and the parallel shearing surfaces of the second shearing elements to pass each other to shear tissue.   
     
     
         45 . The tissue cutting device of  claim 44 , wherein at least some of the parallel shearing surfaces of the first shearing elements lie along the same radial plane. 
     
     
         46 . The tissue cutting device of  claim 45 , wherein the at least some parallel shearing surfaces are spaced apart from each other circumferentially. 
     
     
         47 . The tissue cutting device of  claim 44 , wherein at least some of the parallel shearing surfaces of the first shearing elements are spaced apart from each other radially. 
     
     
         48 . The tissue cutting device of  claim 39 , wherein the elongate tube has a diameter of less than 5 mm. 
     
     
         49 . A tissue cutting device, comprising:
 an elongate tube having a proximal end and a distal end and a central axis extending from the proximal end to the distal end;   a first annular element at the distal end of the elongate tube, the first annular element including a plurality of first shearing elements, each first shearing element having a parallel shearing surface that is parallel to the central axis;   a second annular element at the distal end of the elongate tube and concentric with the first annular element, the second annular element including a plurality of second shearing element, each second shearing element having a parallel shearing surface that is parallel to the central axis,   wherein at least one of the first or second annular elements is rotatable about the central axis, the rotation causing the parallel shearing surfaces of the first shearing elements and the parallel shearing surfaces of the second shearing elements to pass each other to shear tissue.   
     
     
         50 . The tissue cutting device of  claim 49 , wherein at least some of the parallel shearing surfaces of the first shearing elements lie along the same radial plane. 
     
     
         51 . The tissue cutting device of  claim 50 , wherein the at least some of the parallel shearing surfaces are spaced apart from each other axially. 
     
     
         52 . The tissue cutting device of  claim 51 , wherein the at least some of the parallel shearing surfaces are spaced apart from each other circumferentially. 
     
     
         53 . The tissue cutting device of  claim 49 , wherein at least some of the parallel shearing surfaces of the first shearing elements are spaced apart from each other radially. 
     
     
         54 . The tissue cutting device of  claim 49 , wherein the elongate tube has a diameter of less than 5 mm.