# US 10,368,890 B2 · Multi-functional surgical device for neurosurgical and spinal surgery applications > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,368,890 B2 - Document ID: US10368890B2 - Status: Granted - Kind: B2 - Application number: 13/296,745 - Filed: 2011-11-15 - Published: 2012-03-29 - Granted: 2019-08-06 - Earliest claimed: 2008-12-16 - Assignees: Nico Corporation - Applicants: Joseph L. Mark - Inventors: Joseph L. Mark - Web page: https://patentgrep.com/patent/US10368890B2 ## CPC - A61B 17/32002: {with continuously rotating, oscillating or reciprocating cutting instruments} - A61B 10/0275: {with sample notch, e.g. on the side of inner stylet} - A61B 17/1671: {for the spine} - A61B 10/0283: {with vacuum aspiration, e.g. caused by retractable plunger or by connected syringe (A61B10/025, A61B10/0266 take precedence)} - A61B 17/320783: {through side-hole, e.g. sliding or rotating cutter inside catheter} - A61B 2010/0208: {Biopsy devices with actuators, e.g. with triggered spring mechanisms} - A61B 2017/00398: {using powered actuators, e.g. stepper motors, solenoids} - A61B 2017/00738: {part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon} - A61B 2017/00946: {malleable} - A61B 2017/2929: {with a head rotatable about the longitudinal axis of the shaft} - A61B 2017/320028: {with reciprocating movements} - A61B 2017/320032: {Details of the rotating or oscillating shaft, e.g. using a flexible shaft} - A61B 2017/320052: {Guides for cutting instruments} - A61B 2017/320064: {with tissue or sample retaining means} - A61B 2090/0811: {for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument} - A61B 2217/005: with suction drainage system - A61M 1/79: {Filters for solid matter (specially adapted for dental use A61C17/065)} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract A tissue cutting device that is especially suited for neurosurgical applications is disclosed and described. The device includes a handpiece and an outer cannula in which a reciprocating inner cannula is disposed. The device is configured to provide multiple functions during a surgical procedure, in addition to resecting tissue, with a single insertion of the device into a patient. ## Claims ### Claim 1 A tissue removal device, comprising: an outer cannula having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue; an inner cannula disposed in the outer cannula lumen and selectively reciprocable within the outer cannula lumen, the inner cannula having an inner cannula lumen, a proximal end, an open distal end, a hinge, an elongated, continuous relieved portion whereby a portion of a side wall of the inner cannula is removed to allow for bending of the inner cannula, and a cutting edge at the distal end; wherein the relieved portion is positioned proximal to the hinge and has a length extending axially along the inner cannula that is greater than a length of the hinge, and a seal in contact with the proximal end of the outer cannula and disposed around the inner cannula; wherein the inner cannula is configured to selectively reciprocate within the outer cannula lumen between a proximal position and a distal position. ### Claim 2 (depends on 1) The tissue removal device of claim 1, further comprising a vacuum generator in fluid communication with the inner cannula lumen, wherein the vacuum generator is selectively operable to selectively provide vacuum to the outer cannula opening. ### Claim 3 (depends on 2) The tissue removal device of claim 2, wherein reciprocation of the inner cannula is configured to be selectively stopped proximal of the outer cannula opening and the vacuum generator is configured to apply the vacuum through the inner cannula lumen to selectively manipulate tissue without cutting tissue. ### Claim 4 A method of performing a neurosurgical procedure, comprising: providing a tissue removal device comprising: an outer cannula having an outer cannula opening adjacent the distal end, wherein there is an opening to receive tissue and fluids, an inner cannula disposed in the outer cannula and selectively reciprocable within the outer cannula, the inner cannula having a cutting edge at an open distal end to sever tissue, inserting the tissue removal device into a surgical site proximate a target tissue associated with the patient's neurological system; manipulating tissue within the surgical site so as to move the tissue from a first location or orientation to a second location or orientation within the surgical site prior to initiating a cutting operation of the tissue removal device by using the tissue removal device without resecting tissue; drawing tissue into the surgical device by applying vacuum through the inner cannula; and initiating the cutting operation of the tissue removal device after manipulating tissue to the second location or orientation by reciprocating the inner cannula between a proximal position and a distal position after manipulating tissue to the second location or orientation, such that when the inner cannula is in the proximal position, the target tissue is received in the outer cannula opening, and when the inner cannula is in the distal position, the received target tissue is severed from surrounding tissue. ### Claim 5 (depends on 4) The method of claim 4, further comprising aspirating the surgical site prior to reciprocating the inner cannula. ### Claim 6 (depends on 5) The method of claim 5, wherein aspirating is performed simultaneously with manipulating the tissue. ### Claim 7 (depends on 4) The method of claim 4, wherein manipulating the tissue further comprises using the outer cannula as a blunt dissector. ### Claim 8 (depends on 7) The method of claim 7, wherein manipulating the tissue further comprises using a portion of outer cannula to scrape selected tissue. ### Claim 9 (depends on 8) The method of claim 8, wherein the scraping of tissue occurs before the inner cannula is reciprocated. ### Claim 10 (depends on 8) The method of claim 8, wherein the distal opening in the outer cannula is used to scrape tissue. ### Claim 11 (depends on 7) The method of claim 7, wherein manipulating the tissue further comprises using a portion of the outer cannula to move selected tissue. ### Claim 12 (depends on 4) The method of claim 4, wherein manipulating the tissue further comprises using the vacuum to manipulate the tissue in the surgical site. ### Claim 13 (depends on 12) The method of claim 12, wherein during manipulation of the tissue, the distal end of the inner cannula is positioned within the outer cannula such that the distal opening of the outer cannula is in fluid communication with the vacuum. ### Claim 14 (depends on 13) The method of claim 13, wherein the distal end of the inner cannula is positioned proximal of the distal opening of the outer cannula. ### Claim 15 (depends on 12) The method of claim 12, wherein the tissue is manipulated by the vacuum before the inner cannula is reciprocated. ### Claim 16 (depends on 4) The method of claim 4, further comprising aspirating the surgical site while using the portion of the outer cannula as a vessel tamponade. ### Claim 17 (depends on 4) The method of claim 4, wherein manipulating the tissue further comprises manipulating the tissue between reciprocation operations of the inner cannula. ### Claim 18 (depends on 4) The method of claim 4, wherein manipulating the tissue further comprises manipulating the tissue during reciprocation operations of the inner cannula. ### Claim 19 A tissue removal device, comprising: an outer cannula having an outer cannula lumen, a proximal end, a distal end, and an outer cannula opening adjacent the distal end, wherein the opening defines a cutting edge for severing tissue; an inner cannula disposed in the outer cannula lumen and selectively reciprocable within the outer cannula lumen, the inner cannula having an inner cannula lumen, a proximal end, an open distal end, a hinge, an elongated continuous relieved portion whereby a portion of a side wall of the inner cannula is removed to allow for bending of the inner cannula, and a cutting edge at the distal end, wherein the hinge is positioned distal to the relieved portion and wherein the relieved portion has a length extending axially along the inner cannula that is greater than a length of the hinge; a seal in contact with the outer and inner cannulas; wherein the inner cannula is configured to selectively reciprocate within the outer cannula lumen between a proximal position and a distal position; and a vacuum generator in fluid communication with the inner cannula lumen, wherein the vacuum generator is selectively operable to selectively provide varying levels of vacuum to the outer cannula opening.