Medical device for removing an omplanted object using laser cut hypotubes

Abstract

Methods and devices for separating an implanted object, such as a pacemaker lead, from tissue surrounding such object in a patient's vasculature system. Specifically, the surgical device includes a handle, an elongate inner sheath and a circular cutting blade that extends from the distal end of the sheath upon actuating the handle. The circular cutting blade is configured to engage the tissue surrounding an implanted lead and cut such tissue in a coring fashion as the surgical device translates along the length of the lead, thereby allowing the lead, as well as any tissue remaining attached to the lead, to enter the device's elongate shaft. The surgical device has a barrel cam cylinder in the handle assembly that imparts rotation of the blade and a separate cam mechanism in the tip of outer sheath assembly that imparts and controls the extension and retraction of the blade. The barrel cam cylinder and cam mechanism cooperate to cause the blade to rotate in a first direction and extend from and retract in the outer sheath due to a first actuation of the handle and to rotate in a second direction and extend and retract in the outer sheath due to a second actuation of the handle. The inner sheath and outer sheath are constructed of laser-cut hypotubes, thereby allowing the surgical device, particularly the sheath assembly, to have a smaller profile for navigating smaller sized vasculature.

1 - 20 . (canceled) 
     
     
         21 . A device for removing an implanted object, the device comprising:
 an inner sheath assembly;   an intermediate sheath assembly;   an outer sheath assembly; and   a handle assembly that comprises a housing, a trigger, a cutting tip drive mechanism, and a shield drive mechanism carried by the housing, whereupon an actuation of the trigger causes the cutting tip drive mechanism to rotate the inner sheath assembly and a cutting tip relative to the intermediate sheath assembly, and the shield drive mechanism to reconfigure the device from a shielded configuration in which the cutting tip is disposed within the outer sheath assembly to an extended configuration in which a cutting tip at least partially protrudes from the outer sheath assembly and vice versa;   wherein the intermediate sheath assembly comprises an intermediate tip disposed at a distal end of the intermediate sheath assembly;   wherein the inner sheath assembly is transported within the intermediate sheath assembly, the inner sheath assembly comprises the cutting tip;   wherein the outer sheath assembly is transported outside the outer sheath assembly.   
     
     
         22 . The device of  claim 21 , wherein the cutting tip drive mechanism comprises a prime mover. 
     
     
         23 . The device of  claim 22 , wherein the prime mover is a motor. 
     
     
         24 . The device of  claim 21 , wherein the trigger is a button. 
     
     
         25 . The device of  claim 21 , wherein the outer sheath assembly comprises an outer sheath and an outer shield disposed at the distal end of the outer sheath assembly. 
     
     
         26 . The device of  claim 24 , wherein the button shifts relative to the housing. 
     
     
         27 . The device of  claim 25 , wherein the outer sheath assembly is rotatable and translatable relative to the intermediate sheath assembly from a first position to a second position and vice versa. 
     
     
         28 . The device of  claim 22 , wherein the cutting tip drive mechanism includes a cam coupled to an inner sheath of the inner sheath assembly. 
     
     
         29 . The device of  claim 28 , wherein the cam and a follower mechanism are a first cam and the follower mechanism, and further comprises a second cam and the follower mechanism defined by the intermediate tip and the cutting tip, the second cam and the follower mechanism translating the cutting tip relative to the intermediate tip as the cutting tip rotates relative to the intermediate tip. 
     
     
         30 . The device of  claim 21 , wherein the intermediate sheath assembly comprises a longitudinal axis extending between the distal end of the intermediate sheath assembly and a proximal end of the intermediate sheath assembly, wherein the shield drive mechanism is actuated by rotating about the longitudinal axis. 
     
     
         31 . The device of  claim 21 , wherein the shield drive mechanism is rotatably coupled to the handle assembly. 
     
     
         32 . The device of  claim 25 , further comprising a cam and follower mechanism defined by the intermediate tip and the outer shield, the cam and follower mechanism translating the outer sheath relative to an intermediate sheath of the intermediate sheath assembly from a first position to when the outer sheath assembly rotates relative to the intermediate sheath. 
     
     
         33 . The device of  claim 32 , further comprising:
 in response to the outer shield placed in the first position, a cutting surface of the cutting tip configured to remain disposed within the outer shield as the cam and follower mechanism is configured to translate the cutting tip relative to the intermediate tip and to a cutting tip rotation relative to an intermediate tip position.   
     
     
         34 . A device for removing an implanted object from a body vessel, the device comprising:
 an inner sheath assembly;   an intermediate sheath assembly;   an outer sheath assembly rotatably disposed radially outward of the intermediate sheath assembly, the outer sheath assembly comprises an outer sheath and an outer shield disposed at a distal end of the outer sheath assembly; and   a handle assembly that comprises a housing, a trigger, a cutting tip drive mechanism, and a shield drive mechanism carried by the housing, whereupon an actuation of the trigger causes the cutting tip drive mechanism to rotate the inner sheath assembly and a cutting tip relative to the intermediate sheath assembly, and the shield drive mechanism to reconfigure the device from a shielded configuration in which the cutting tip is disposed within the outer sheath assembly to an extended configuration in which a cutting tip at least partially protrudes from the outer sheath assembly   wherein the intermediate sheath assembly comprises an intermediate tip disposed at the distal end of the intermediate sheath assembly;   wherein the inner sheath assembly is disposed within the intermediate sheath assembly, the inner sheath assembly comprises the cutting tip.   
     
     
         35 . The device of  claim 34 , wherein the cutting tip drive mechanism comprises a prime mover. 
     
     
         36 . The device of  claim 35 , wherein the prime mover is a motor. 
     
     
         37 . The device of  claim 34 , wherein the trigger is a button. 
     
     
         38 . The device of  claim 37 , wherein the button shifts relative to the housing. 
     
     
         39 . The device of  claim 35 , wherein the cutting tip drive mechanism includes a cam coupled to an inner sheath of the inner sheath assembly. 
     
     
         40 . The device of  claim 39 , wherein the cam and a follower mechanism are a first cam and the follower mechanism, and further comprises a second cam and the follower mechanism defined by the intermediate tip and a cutting tip, the second cam and the follower mechanism translating the cutting tip relative to the intermediate tip as the cutting tip rotates relative to the intermediate tip.