Systems, methods, and devices for endoscopic nerve release

#The present disclosure relates generally to a surgical device for and a method of performing endoscopic surgery. More specifically, the present disclosure relates to endoscopic surgical devices and a method for use in minimally invasive surgical procedures to perform peripheral nerve decompression or release.

#Nerves run from the spinal cord throughout the body through ‘tunnels’. These protective tunnels are narrower in sections leading to the hands and feet, and are prone to compressing or pinching nerves. When an individual nerve is compressed, it causes symptoms only in the areas served by that nerve. With carpal tunnel syndrome, for example, a patient will have sensory complaints on the palm side of the thumb and the index and middle fingers.

#Common nerve compression syndromes include carpal tunnel syndrome, cubital tunnel syndrome, tarsal tunnel syndrome and radial tunnel syndrome. Carpal tunnel syndrome is the compression of the median nerve as it passes through the carpal tunnel in the wrist. Symptoms include pain and paresthesias in the median nerve distribution. Cubital tunnel syndrome is the most common form of entrapment of the ulnar nerve caused by the compression or traction of the ulnar nerve at the elbow. The ulnar nerve runs through the passage known as the cubital tunnel just behind the elbow. Since the ulnar nerve lies directly next to the bone on the inner portion of the elbow, excessive pressure on the nerve causes numbness, tingling and pain in the elbow, forearm, hand and/or fingers leading to cubital tunnel syndrome. Tarsal tunnel syndrome is caused by the compression of the main nerve (posterior tibial nerve) that passes under the medial or inside part of the ankle. The tibial nerve follows a curved route down the back portion of the leg, to the ankle, where it turns and curls below the inside of the ankle. When the nerve is entrapped in the tarsal tunnel, swelling occurs around the nerve and the ensuing scarring of the nerve inhibits blood flow to the nerve. As the ankle joint continues to move, the nerve is further compressed and the ability of the nerve to properly function is diminished. Symptoms include burning or numbness usually at the bottom of the foot that might aggravate while standing or walking. Radial tunnel syndrome is compression of the radial nerve in the proximal forearm. Compression at the elbow may be caused by trauma, ganglia, lipomas, bone tumors, or radiocapitellar (elbow) synovitis. Symptoms include lancinating pain in the dorsum of the forearm and lateral elbow. Pain is precipitated by attempted extension of the wrist and fingers and forearm supination.

#The foregoing and other features, aspects and advantages of the embodiments of the inventions are described in detail below with reference to the drawings of various embodiments, which are intended to illustrate and not to limit the inventions. The drawings comprise the following figures in which:

#FIG. 1 illustrates a system that can preferably be included for use in nerve release surgery according to an embodiment.

#FIG. 2 illustrates a perspective view of a knife unit in accordance with one embodiment.

#Although several embodiments, examples and illustrations are disclosed below, it will be understood by those of ordinary skill in the art that the inventions described herein extend beyond the specifically disclosed embodiments, examples and illustrations, and include other uses of the inventions and obvious modifications and equivalents thereof. Embodiments of the invention are described with reference to the accompany figures, wherein like numerals refer to like elements throughout. The terminology used in the description presented herein is not intended to be interpreted in any limited or restrictive manner simply because it is being used in conjunction with a detailed description of certain specific embodiments. In addition, embodiments described herein can comprise several novel features and no single feature is solely responsible for its desirable attributes or is essential to practicing the inventions herein described.

#Nerves run from the spinal cord throughout the body through ‘tunnels’. These protective tunnels are narrower in sections leading to the hands and feet, and are prone to compressing or pinching nerves. Common nerve compression syndromes include carpal tunnel syndrome, cubital tunnel syndrome, tarsal tunnel syndrome and radial tunnel syndrome.

#A traditional method for treating nerve compression syndromes comprises simply cutting the tissue or fascia directly above the nerve either by endoscopic methods or by other surgical methods. These methods release the pressure on the nerve trunk by the surgical excision of constricting bands or removal of constricting fibrous tissue. For example, some standard surgical procedures to treat these problems include decompression of the nerve via open carpal tunnel release (OCTR) or endoscopic methods. OCTR generally requires a large incision of approximately 6 inches, which leaves a huge scar, causes postoperative pain, requires much longer recovery time and can lead to morbidly lasting up to six months. Alternately, endoscopic methods require only a 15 mm to 25 mm skin incision, provide excellent cosmetic results and a rapid recovery, but still suffer from some disadvantages such as higher complication rates due to incomplete release of the ligament and injury to the adjoining nerves.