Minimally invasive intact recovery of tissue

Apparatus for retrieving a tissue volume of given peripheral extent, comprising:

• a delivery cannula having an outer surface surmounting an interior channel and extending from a proximal end portion along a longitudinal axis to a forward region having a distal end positionable in confronting adjacency with said tissue volume;
• a capture component positioned within said delivery cannula interior channel, having a forward portion extending to a forwardly disposed electrically conducting electrosurgical cutting leading edge portion and being extendible toward an outer peripheral dimension effective for the circumscriptive engagement of said tissue volume peripheral extent when moved along said longitudinal axis to egress from said delivery cannula:
• a housing assembly having forward and rearward portions and coupled in supporting relationship with said delivery cannula at said proximal end portion;
• a drive assembly including a drive component extending from driving engagement with said capture component within said delivery cannula interior channel into said housing and having a drive member with a driven surface fixed to said drive component in driving relationship, said drive member being movable along said axis from a start orientation to a capture position;
• an actuator assembly within said housing including an elongate rotational translation component located in generally parallel relationship with said drive assembly, fixed for rotation at said housing forward portion and extending rearwardly therefrom to a self-aligning coupling assembly having a forward driving connection portion coupled therewith and an rearward driven connection portion, a motor assembly having a rotational drive output coupled in driving relationship with said coupling assembly rearward driven connection portion, said motor assembly being mounted in self-aligning confinement within said housing assembly, having non-rotational freedom of movement extending from said coupling assembly and being actuable to drive said translation component from said coupling assembly;
• a transfer assembly mounted in driven relationship with said rotational translation component having a home position in association therewith and having an engaging portion engagable in driving relationship with said drive member driven surface to effect movement of said drive member along said axis when said motor assembly is actuated;
• and
• a terminal assembly responsive to an applied control input for effecting the application of electrosurgical cutting current to said capture component leading edge portion.

A system for carrying out a procedure for retrieving a tissue volume, comprising:

• a delivery cannula having an outer surface surmounting an interior channel and extending from a proximal end portion along a longitudinal axis to a forward region having a distal end positionable in confronting adjacency with said tissue volume;
• a capture component positioned within said delivery cannula interior channel at said forward region having a containment structure extending to a forwardly disposed pursing cable assembly energizable to define an electrosurgical cutting leading edge, said containment structure being extensible from said forward region at an angle of attack with respect to said axis to define an outer periphery having a dimension effective for the circumscriptive engagement of said tissue volume and subsequently extendable while said leading edge is drawn in contraction toward said axis by a pursing stress applied to said pursing cable assembly;
• a housing assembly coupled in supporting relationship with said delivery cannula at said proximal end portion;
• a drive assembly including a drive component extending from driving engagement with said containment structure within said delivery cannula into said housing and having a drive member with a driven surface fixed to said drive component in driving relationship, said drive member being movable along said axis from a start orientation to a capture position
• a translation component within said housing located in generally parallel relationship with said drive assembly, responsive to a rotational drive input to provide a translation drive output;
• a transfer assembly within said housing, coupled in driven relationship with said translation drive output, having a home position, having an engaging portion engagable in driving relationship with said drive member driven surface to effect movement of said drive member along said axis;
• a motor within said housing for providing said rotational drive input to said translation component, having load current characteristics, responsive to a forward input to provide a forward said rotational drive input and to a reverse input to provide a rearward said rotational drive input;
• an electrosurgical generator having an output connectable with said capture component pursing cable assembly and responsive to an energize input to provide electrosurgical cutting energy having a voltage level at said output;
• and
• a control assembly connected with said motor and said electrosurgical generator, responsive to a capture input to provide said energize input to said electrosurgical generator and effect application of said electrosurgical cutting energy to said pursing cable assembly and to provide said forward input to said motor, responsive to terminate said forward input when a said motor load characteristic corresponds with the presence of said drive member at said capture position.

A system for retrieving a tissue volume, comprising:

• a delivery cannula having an outer surface surmounting an interior channel and extending from a proximal end portion along a longitudinal axis to a forward region, having a distal end positionable in confronting adjacency with said tissue volume;
• a capture component positioned within said delivery cannula interior channel, having a forward portion extending to a forwardly disposed electrically conducting electrosurgical cutting leading edge portion extendable outwardly from said delivery cannula forward portion to establish an outer peripheral dimension selected for the circumscriptive engagement of said tissue volume and subsequently extendable while being drawn in contraction toward said longitudinal axis to a capture orientation;
• a deployment assembly extending within said interior channel, drivably coupled with said capture component and controllable to effect said extension of said capture component and including an input assembly for transmitting an electrical cutting energy input to said leading edge portion;
• an electrosurgical generator connectable with a power input, including:
• an input treatment network responsive to said power input to derive an interim voltage output of first value;
• a first inverter network responsive to said interim voltage and to a first inverter control input to derive a first alternating voltage output of second value less than said first value at a first inverter output;
• a first inverter control network coupled with said first inverter network and deriving said first inverter control input;
• a rectifier network responsive to said first alternating voltage output to derive a link output at a d.c. voltage level corresponding with said first alternating voltage output second value;
• a second inverter network having an input, and responsive to said link output to derive a second alternating voltage output at an electrosurgical frequency value and with voltage amplitudes established by said link output d.c. voltage level;
• a second inverter control network coupled with said second inverter network to effect derivation of said second alternating voltage output electrosurgical frequency;
• a high voltage transformer having a primary side responsive to said second alternating voltage output and a secondary side deriving said electrical cutting energy input at an electrosurgical voltage level and at said electrosurgical frequency;
• and
• an output stage coupled with said high voltage transformer secondary side and connectable in electrical communication with said input assembly of said deployment assembly.

Apparatus for retrieving a tissue volume, comprising:

• a delivery cannula having an outer surface surmounting an interior channel and extending from a proximal end portion along a longitudinal axis to a forward region having a distal end positionable in confronting adjacency with said tissue volume;
• a capture component positioned within said delivery cannula at said forward region, having a forward portion comprising a plurality of leafs having widths and thicknesses effective for lateral stability and flexure, each leaf having a length extending from a base portion to said forward portion and having a tip portion, each said tip portion having a pursing eyelet, a retainer groove extending along the length of each said leaf, a cable guide fixed to each said leaf at said retainer groove, the base portions of said leafs being interconnected to define a tube structure base supporting forwardly extending discrete said leafs at said forward portion, a pursing cable assembly comprised of a plurality of discrete electrically conductive cables each slideably extending through a said cable guide and an associated said pursing eyelet and from said pursing eyelet extending to and connected to the tip portion of a next adjacent said leaf, a guidance assembly fixed to said delivery cannula at said forward region and configured to effect deployment of said leafs mutually outwardly from said longitudinal axis;
• a housing assembly coupled in supporting relationship with said delivery cannula at said proximal end portion;
• a drive assembly including a drive rod connected with said capture component tube structure base within said delivery cannula interior channel and extending into said housing assembly, said drive rod being drivably movable along said axis to effect extension of said leaf forward portions and associated said cables mutually outwardly from said guidance assembly to establish a periphery of predetermined effective diametric extent defined by said tip portions, thereafter said drive assembly controlling movement of said cables while said drive rod is moved along said axis to effect a mutually inward flexure of said leaf tip portions to a capture orientation for enveloping said tissue volume;
• and
• an actuator and control assembly drivably engagable with said drive assembly to effect movement of said drive rod and to effect electrosurgical cutting energization of said cables.

In a system for retrieving a tissue volume wherein a re-usable component is provided having a re-usable housing connected in electrical communication with an electrosurgical generator and control assembly and having a receiving region for receiving a replaceable component extending about a longitudinal region axis rearwardly from a forward portion, a motor assembly within said re-usable housing coupled in driving association with a translation component, a transfer assembly within said re-usable housing coupled in driven relationship with said translation component and having a transfer yoke with oppositely disposed drive surfaces movable forwardly and rearwardly in parallel with said region axis in adjacency with said receiving region from and to a home position, and an input terminal assembly within said re-usable housing at a location adjacent said receiving region connectable in said electrical communication with said electrosurgical generator, an improved replaceable component, comprising;

• a support housing dimensioned for removable operative association with said re-usable housing when at an operative position within said receiving region, said support housing having rearward and forward portions and disposed about said longitudinal region axis when positioned within said receiving region;
• a delivery cannula having an outer surface surmounting an interior channel and extending from a proximal end portion fixed to said support housing forward portion along a longitudinal cannula axis to a forward region having a distal end positionable in confronting adjacency with said tissue volume;
• a capture component positioned within said delivery cannula interior channel at said forward region, having a forward portion extending to a forwardly disposed pursing cable assembly energizable to define an electrosurgical cutting leading edge portion, and including at least two tensionable cables extending from said pursing cable assembly into said inner channel, said leading edge of said expansible forward portion being extendable from said delivery cannula laterally outwardly and forwardly toward an outer peripheral dimension having a predetermined diametric extent effective to provide a circumspective positioning about said tissue volume and subsequently extendable while being drawn in contraction toward said cannula axis by stress at said pursing cable assembly to a capture orientation enveloping said tissue volume;
• a drive assembly including a drive rod connected in driving relationship with said capture component and extending to driven connection with a drive member within said support housing and movable therein from a start position along said cannula axis, said drive member having oppositely disposed ears extending outwardly from said support housing, each having a driven surface abuttably engageable with said transfer yoke drive surfaces when said support housing is at said operative position;
• an elongate support member mounted within said support housing and extending along said cannula axis to said rearward region and slidably supporting said drive member;
• a cable stop member fixed to said support member at a stop position deriving said capture component forward portion outer peripheral dimension;
• a cable terminator component mounted for movement upon said support member, coupled with and drivably movable by said cables from an initial position into engagement with said cable stop member at said stop position;
• and
• an electrical contact assembly mounted upon said housing electrically coupled with said cables and engaged with said reusable housing contained input terminal assembly when said support housing is at said operative position.

The method for isolating and retrieving a tissue volume of given peripheral extent within adjacent tissue of a patient comprising the steps of:

• (a) providing an electrosurgical generator controllable to derive an electrosurgical cutting output at a cutting voltage level;
• (b) providing a tissue retrieval instrument having a delivery cannula with an internal channel and extending from a proximal end portion along a longitudinal axis to a forward region having a tip, said instrument having a capture component positioned within said delivery cannula internal channel having a forward portion extending to a forwardly disposed pursing cable assembly energizable to define an electrosurgical cutting leading edge, said capture component being actuable to cause said leading edge to extend from said delivery cannula laterally outwardly and forwardly toward a maximum peripheral extent selected to correspond with said given peripheral extent and subsequently extendable while being drawn toward said axis to a capture orientation, a controllable motor assembly, a translation assembly, a transfer assembly and a drive assembly configured for actuating said capture component, said instrument further including a precursor electrode assembly mounted at said delivery cannula tip and energizable for electrosurgical cutting from said electrosurgical generator;
• (c) providing a control assembly, electrically coupled with said electrosurgical generator and said instrument, having a position switch, an arm switch and a capture switch, each said switch having an on condition and an off condition;
• (d) electrosurgically exciting said precursor electrode by actuating said position switch to said on condition causing said control assembly to assume a position mode;
• (e) positioning said delivery cannula within said adjacent tissue in a manner wherein said tip is in confronting adjacency with said tissue volume;
• (f) causing said control assembly to enter an arm capture mode terminating said excitation of said precursor electrode, terminating said position mode and disabling said position switch, by actuating said arm switch to said on condition;
• (g) causing said control assembly to enter a capture mode effecting the electrosurgical excitation of said pursing cable assembly and controlling said motor to commence actuation of said capture component by applying forward drive to said translation assembly and effecting forward movement of said translation assembly in engagement with said drive assembly to actuate said capture component to effect an isolation and envelopment of said tissue volume, by actuating said capture switch to said on condition;
• (h) detecting the reaching of said capture orientation by said capture component with said control assembly to provide a capture complete mode terminating said capture mode, controlling said motor to terminate said actuation of said capture component and terminating said electrosurgical excitation of said pursing cable assembly;
• and
• (i) removing said delivery cannula with the capture component retained isolated tissue volume from said adjacent tissue.

The method for isolating and retrieving a tissue volume of given peripheral extent within adjacent tissue of a patient, comprising the steps of:

• (a) providing an electrosurgical generator controllable to derive an electrosurgical cutting output at a cutting voltage level;
• (b) providing a tissue retrieval instrument having a delivery cannula with an internal channel and extending from a proximal end portion along a cannula axis to a forward region having a tip, said instrument having a capture component positioned within said delivery cannula internal channel, said capture component having a forward portion extending to a forwardly disposed pursing cable assembly energizable to define an electrosurgical cutting leading edge, said capture component being actuable to cause said leading edge to extend from said delivery cannula laterally outwardly and forwardly toward a maximum peripheral extent selected to correspond with said given peripheral extent and subsequently extendable while being drawn toward said cannula axis to a capture orientation, an energization controlled motor exhibiting a load characteristic, a translation assembly coupled in driven relationship with said motor, a transfer assembly having a drive surface and movable to and from a home position, and a drive assembly coupled in driven relationship with said capture component for effecting the actuation thereof and having a driven surface abuttably engagable with said transfer assembly drive surface and when being at an initial position spaced a test distance from said transfer assembly drive surface when said transfer assembly is at said home position
• (c) providing a control assembly, electrically coupled with said electrosurgical generator and said instrument, having a fault condition output, having an arm switch, and a capture switch;
• (d) positioning said delivery cannula within said adjacent tissue in a manner wherein said tip is in confronting adjacency with said tissue volume;
• (e) actuating said arm switch to cause said control assembly to enter an arm capture mode;
• (f) actuating said capture switch in the presence of said arm capture mode to cause said control assembly to enter a capture mode and to control said motor to effect test movement of said translation assembly along said test distance for a test interval;
• (g) monitoring said motor load characteristic with said control assembly during said test interval, deriving a said fault condition and terminating said capture mode when said load characteristic exceeds a test threshold level;
• (h) terminating said test movement following said test interval in the continued presence of said capture mode;
• (i) then controlling said electrosurgical generator with said control assembly to effect the electrosurgical excitation of said pursing cable assembly in the presence of said capture mode for an initial interval;
• controlling said motor with said control assembly while continuing said electrosurgical excitation of said pursing cable assembly in the presence of said capture mode to effect actuation of said capture component by a drive engagement of said transfer assembly drive surface with said drive assembly driven surface to effect isolating envelopment of said tissue volume;
• (k) detecting the presence of said capture component capture orientation with said control assembly to enter a capture complete mode wherein said electrosurgical generator is controlled to terminate said electrosurgical excitation of said pursing cable assembly;
• and
• (l) removing said delivery cannula, with the capture component enveloped isolated tissue volume, from said adjacent tissue.

Apparatus for retrieving a tissue volume comprising:

• a delivery cannula having an outer surface surmounting an interior channel and extending from a proximal end portion along a longitudinal axis to a forward region having a distal end positionable in confronting adjacency with said tissue volume;
• a capture component positioned within said delivery cannula interior channel, having a forward portion extending to a forwardly disposed electrically conducting electrosurgical cutting leading edge portion and being extendable toward an outer peripheral dimension effective for the circumscriptive engagement of said tissue volume and contractible thereafter toward said axis to envelope said tissue volume when moved along said longitudinal axis to egress from said delivery cannula;
• a hand grippable housing having left and right side portions extending outwardly from a medial plane with a housing forward portion coupled in supporting relationship with said delivery cannula at said proximal end portion;
• a deployment assembly extending within said interior channel from said housing, drivably coupled with said capture component and energizable to effect said movement of said capture component along said longitudinal axis;
• a first switch positioned adjacent said medial plane at said housing forward portion and manually actuable to energize said deployment assembly;
• a right grip connector fixed to said housing right side portion adjacent said forward portion and said first switch;
• a left grip connector fixed to said housing left side portion adjacent said forward portion and said first switch;
• and
• a manually graspable stabilizer grip removably connectable with said right grip connector or said left grip connector.