Soft and hard tissue excisional devices and methods

Abstract

A device may comprise a work element, an outer tube co-axially disposed around a portion of the work element and a collar assembly. The work element may be configured to rotate and define proximal and distal ends, and may comprise a body portion, one or more articulable beak(s) configured to cut tissue, and a beak actuation portion. The collar assembly may be coupled to the work element away from the articulable beak(s), and may comprise a distal collar element coupled to the body portion, a middle collar element coupled to the outer tube and a proximal collar element coupled to the beak actuation portion. The distal collar element may comprise a first peripheral surface that extends around the distal collar element and that faces the proximal end and the middle collar element may comprise a second peripheral surface that that extends around the middle collar element, faces the distal end and at least partially contacts the first peripheral surface. The first and second peripheral surfaces each may comprise a smooth undulating surface that comprises a plurality of peaks and valleys. The distal, middle and proximal collar elements may be configured to control opening, closing, extending and retracting the articulable beak(s) by rotating in synchronicity, rotating differentially and/or moving toward the distal or proximal ends.

1 . A device, comprising:
 a work element configured to rotate and defining a proximal end and a distal end away from the proximal end, the work element comprising a body portion, at least one articulable beak disposed at a distal end of the body portion and configured to cut tissue, and a beak actuation portion;   an outer tube co-axially disposed around a portion of the work element;   a collar assembly coupled to the work element away from the at least one articulable beak, the collar assembly comprising at least a distal collar element coupled to the body portion of the work element, a middle collar element coupled to the outer tube and a proximal collar element coupled to the beak actuation portion, the distal collar element comprising a first peripheral surface that extends around the distal collar element and that faces the proximal end, the middle collar element comprising a second peripheral surface that that extends around the middle collar element, faces the distal end and at least partially contacts the first peripheral surface;   wherein the first peripheral surface is a smooth surface that comprises a plurality of first peaks and a plurality of first valleys and the second peripheral surface is a smooth surface that comprises a plurality of second peaks and a plurality of second valleys, and   wherein the distal, middle and proximal collar elements are configured to control opening, closing, extending and retracting the at least one articulable beak by at least one of rotating in synchronicity, rotating differentially, moving toward the distal end and moving toward the proximal end.   
     
     
         2 . The device of  claim 1 , wherein the work element is a single tube-shaped piece of material comprising a plurality of cuts therein that defines the at least one articulable beak, the body portion and the beak actuation portion. 
     
     
         3 . The device of  claim 1 , wherein the outer tube is configured to rotate relative to the body portion of the work element to cause the first and second peripheral surfaces to slide against one another and the at least one articulable beak to cyclically open and close. 
     
     
         4 . The device of  claim 1 , wherein the outer tube is configured for limited travel in a distal or proximal direction and wherein pulling the outer tube in the proximal direction relative to the work element causes the middle collar element to pull the proximal collar in the proximal direction and to close the at least one articulable beak. 
     
     
         5 . The device of  claim 1 , wherein the body portion of the work element is configured for limited travel in a distal or proximal direction and wherein pushing the body portion in the distal direction relative to the outer tube causes the distal collar element to move distally relative to the middle collar and to close the at least one articulable beak. 
     
     
         6 . The device of  claim 1 , wherein differential rotation of the body portion relative to the outer tube cyclically opens and closes the at least one articulable beak. 
     
     
         7 . The device of  claim 6 , wherein differential rotation of the distal and middle collars causes the first peaks and first valleys of the first peripheral surface to slide against the second peaks and second valleys of the second peripheral surface. 
     
     
         8 . The device of  claim 1 , wherein differential axial movement of the body portion relative to the outer tube cyclically at least partially opens and closes the at least one articulable beak. 
     
     
         9 . The device of  claim 1 , wherein a first profile defined by the first peaks and first valleys of the first peripheral surface and a second profile defined by the second peaks and second valleys of the second peripheral surface define a pattern, upon rotation of at least the collar assembly, of at least partial opening and at least partial closing the at least one articulable beak in operation of the device. 
     
     
         10 . The device of  claim 1 , wherein a differential rotation of the body portion relative to the outer tube defines a rate at which the at least one articulable beak cyclically at least partially opens and closes. 
     
     
         11 . The device of  claim 1 , wherein the collar assembly is further configured such that axially-directed pulsed movement of at least the collar assembly causes the at least one articulated beak to undergo a jackhammer-like reciprocating motion in at least a partially opened or in at least a partially closed configuration. 
     
     
         12 . The device of  claim 1 , wherein a depth of the first and second valleys and a height of the first and second peaks define a degree to which the at least one articulable beak cyclically opens and closes as the peripheral surfaces of the distal and middle collar elements slide against each other. 
     
     
         13 . The device of  claim 1 , wherein the first peripheral surface matches the second peripheral surface such that the first peripheral surface mates in intimate contact with the second peripheral surface at least once each time one of the first and second peripheral surfaces fully rotates around the other of the first and second peripheral surface. 
     
     
         14 . A device, comprising:
 a work element configured to rotate and defining a proximal end and a distal end away from the proximal end, the work element comprising a body portion, at least one articulable beak disposed at a distal end of the body portion and configured to cut tissue, and a beak actuation portion;   a proximal sheath comprising a resilient portion near a distal end thereof, the proximal sheath being coupled to the beak actuation portion of the work element;   a distal sheath partially disposed over the work element and coupled to the proximal sheath distally relative to the resilient portion thereof;   a collar assembly coupled to the work element away from the at least one articulable beak, the collar assembly comprising at least a first collar element coupled to the body portion of the work element and a second collar element coupled to the distal sheath, the first collar element comprising a first peripheral surface that extends around the first collar element and that faces the proximal end and the second collar element comprising a second peripheral surface that that extends around the second collar element, faces the distal end and at least partially contacts the first peripheral surface;   wherein the first peripheral surface is a smooth surface that comprises a plurality of first peaks and a plurality of first valleys and the second peripheral surface is a smooth surface that comprises a plurality of second peaks and a plurality of second valleys, and   wherein the proximal sheath, the distal sheath and the collar assembly are configured to control opening, closing, extending and retracting the at least one articulable beak by at least one of rotating in synchronicity, rotating differentially, moving toward the distal end and moving toward the proximal end.   
     
     
         15 . The device of  claim 14 , wherein the work element is a single tube-shaped piece of material comprising a plurality of cuts therein that defines the at least one articulable beak, the body portion and the beak actuation portion. 
     
     
         16 . The device of  claim 14 , wherein differential rotational motion of the distal tube and of the proximal tube is configured to cause the first and second peripheral surfaces to slide against one another and the at least one articulable beak to cyclically open and close. 
     
     
         17 . The device of  claim 14 , wherein the distal tube is configured for limited travel in a distal or proximal direction and wherein pulling the distal tube in the proximal direction relative to the work element causes the second collar element to pull the proximal sheath in the proximal direction and to close the at least one articulable beak. 
     
     
         18 . The device of  claim 14 , wherein differential rotation of the distal tube relative to the proximal tube cyclically opens and closes the at least one articulable beak. 
     
     
         19 . The device of  claim 14 , wherein differential rotation of the first and second collars causes the first peaks and first valleys of the first peripheral surface to slide against the second peaks and second valleys of the second peripheral surface. 
     
     
         20 . The device of  claim 14 , wherein differential axial movement of the distal sheath relative to the proximal sheath cyclically at least partially opens and closes the at least one articulable beak. 
     
     
         21 . The device of  claim 14 , wherein a first profile defined by the first peaks and first valleys of the first peripheral surface and a second profile defined by the second peaks and second valleys of the second peripheral surface define a pattern of at least partial opening and at least partial closing the at least one articulable beak in operation of the device. 
     
     
         22 . The device of  claim 14 , wherein a differential rotation of the distal sheath relative to the proximal sheath defines a rate at which the at least one articulable beak cyclically at least partially opens and closes. 
     
     
         23 . The device of  claim 14 , wherein the distal sheath is configured such that a periodic axial movement thereof causes the at least one articulated beak to undergo a jackhammer-like reciprocating motion in at least a partially opened or in at least a partially closed configuration 
     
     
         24 . The device of  claim 14 , wherein a depth of the first and second valleys and a height of the first and second peaks define a degree to which the at least one articulable beak cyclically opens and closes as the peripheral surfaces of the first and second collar elements slide against each other. 
     
     
         25 . The device of  claim 14 , wherein the first peripheral surface matches the second peripheral surface such that the first peripheral surface mates in intimate contact with the second peripheral surface at least once each time one of the first and second peripheral surfaces fully rotates around the other of the first and second peripheral surface. 
     
     
         26 . A method, comprising:
 providing a device comprising a work element configured to rotate and defining a proximal end and a distal end away from the proximal end, the work comprising, at the distal end thereof, at least one articulable beak configured to cut tissue; and a collar assembly coupled to the work element away from the at least one articulable beak, the collar assembly comprising at least a first collar element comprising a first peripheral undulating surface that faces the proximal end and a second collar element comprising a second peripheral undulating surface that faces the distal end and that at least partially contacts the first peripheral undulating surface, the first and second collar elements being configured to rotate in synchronism or differentially relative to one another;   rotating the work element;   inserting at least the distal end of the rotating work element into tissue;   controlling movements of at least the first and second collar elements to at least one of:   at least partially open the at least one articulable beak to core through tissue;   at least partially close the at least one articulable beak to dissect through tissue;   cause cyclic at least partial openings and closings of the at least one articulable beak as the first and second peripheral undulating surfaces slide against one another; and   cause cyclic short excursions of the at least one articulable beak toward the distal end and back toward the proximal end in a jackhammer-like motion.   
     
     
         27 . The method of  claim 26 , wherein providing is carried out with the work element being a single tube-shaped piece of material comprising a plurality of cuts to define the at least one articulable beak.