WO2013172998A4 - Method and apparatus for minimally invasive skin and soft-tissue incisions - Google Patents

Method and apparatus for minimally invasive skin and soft-tissue incisions Download PDF

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Publication number
WO2013172998A4
WO2013172998A4 PCT/US2013/035671 US2013035671W WO2013172998A4 WO 2013172998 A4 WO2013172998 A4 WO 2013172998A4 US 2013035671 W US2013035671 W US 2013035671W WO 2013172998 A4 WO2013172998 A4 WO 2013172998A4
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WO
WIPO (PCT)
Prior art keywords
scalpel
blades
barrel
targeting guide
bone
Prior art date
Application number
PCT/US2013/035671
Other languages
French (fr)
Other versions
WO2013172998A2 (en
WO2013172998A3 (en
Inventor
Herbert D. HUDDLESTON
Original Assignee
Huddleston Herbert D
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Huddleston Herbert D filed Critical Huddleston Herbert D
Priority to EP13791608.6A priority Critical patent/EP2844153A4/en
Publication of WO2013172998A2 publication Critical patent/WO2013172998A2/en
Publication of WO2013172998A3 publication Critical patent/WO2013172998A3/en
Publication of WO2013172998A4 publication Critical patent/WO2013172998A4/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3201—Scissors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1717—Guides or aligning means for drills, mills, pins or wires for applying intramedullary nails or pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3209—Incision instruments
    • A61B17/32093—Incision instruments for skin incisions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3209—Incision instruments
    • A61B17/3211—Surgical scalpels, knives; Accessories therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8875—Screwdrivers, spanners or wrenches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/90—Guides therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00353—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320052—Guides for cutting instruments

Abstract

A method and apparatus for creating minimal skin incisions and soft tissue tunnels, particularly useful in the insertion of transverse or oblique screws through a bone and the holes in a locking nail embedded within the intra-medullary cavity of the said bone. A unique surgical tool, as described herein, is used in conjunction with the novel method herein described, wherein the surgical tool is used in conjunction with a targeting guide and targeting guide tunnel to create skin and soft-tissue tunnels that are precise, of minimal size, and minimally traumatic for the patient, and very quick and easy for the surgeon to create and to repair.

Claims

54
AMENDED CLAIMS
received by the International Bureau on 31 DEC 2013 (31 .12.2013)
1. A scalpel for making a skin incision and soft-tissue path from the skin to a bone used in conjunction with a targeting guide and targeting guide tunnel to guide the scalpel along a fixed path.
2. A scalpel with two blades for making a skin incision and soft-tissue pat¾ from the skin to a bone used in conjunction with a targeting guide and targeting guide tunnel to guide the scalpel along a fixed path, the scalpel having a barrel portion which is of a given size to enable the barrel portion to be passed through the targeting guide tunnel, the scalpel having at least two movable blades a: a leading edge of the barrel, each blade having a side with a cutting edge; and a mechanism for radially narrowing each of the blades of the scalpel for inward passage through the targeting guide tunnel, the mechanism also radially restoring the two blades to their full width after passage through the targeting guide tunnel to expose each cutting edge of the two blades in preparation for making a skin incision, the mechanism also radially narrowing the cutting edge for withdrawal of the blades through the targeting guide tunnel after completion of a surgical procedure. 55
A scalpel that has a handle that is long enough to enable the scalpel and handle to traverse the length of a targeting guide tunnel and further extend beyond skin and soft-tissue of a patient to a patient's bone.
A method for making a skin incision and soft-tissue path from the skin 1o a bone, used in conjunction with a targeting guide and targeting guide tunnel.
A method for making a skin incision and soft-tissue path from the skin to a bone, used in conjunction with a targeting guide and targeting guide tunnel, wherein the scalpel makes an incision larger than the inner diameter of the targeting guide tunnel.
A scalpel for making a skin incision and soft-tissue path from the skin to a bone, used in conjunction with a targeting guide and targeting guide tunnel, that has blades that will contract into the scalpel handle for inward passage thro gh the targeting guide tunnel, expand to make an antegrade cut through the skn and soft tissues, and contract after making the cut so that it can be withdrawn back out through the skin and soft tissue tunnel and targeting guide tunnel.
A surgical scissors guided by and used in conjunction with a targeting guide and targeting guide tunnel.
8. A method in which a surgical scissors is used in conjunction with a targeting guide and targeting guide tunnel for making a cruciate incision in the deep fascia.
9. A method in which a scalpel used in conjunction with a targeting guide and
targeting guide runnel has two mobile blades as its cutting mechanism f or making a cruciate incision in the deep fascia.
A method in which a scalpel used in conjunction with a targeting guide and targeting guide tunnel has one mobile blade as its cutting mechanism fcr making an incision in the skin and soft tissues.
11. The method of making a minimal cruciate incision in the deep fascia for passage of instruments down to the bone in the operation of inserting a locking screw into the bone and through a passage in a locking nail.
12. A surgical instrument that has a dual function, both as a double-edged,
sharp-pointed surgical scalpel and a surgical scissors.
A scalpel for making a skin incision and soft-tissue path from the skin to a bone, used in conjunction with a targeting guide having at least one targeting tunnel aligned with a corresponding at least one screw hole in a locking nail positioned within the bone, the scalpel comprising:
a. the scalpel having a barrel portion which is of a given size to enable the
barrel portion to be passed through the targeting guide tunnel; b. the scalpel having at least two movable blades at a leading edgei- of the
barrel, each blade having a side with a cutting edge; and
c. means for radially narrowing each of the blades of the scalpel for inward passage through the targeting guide tunnel, a means for radially restoring the two blades to their full width after passage through the targeiing guide tunnel to expose each cutting edge of the two blades in preparation for making a skin incision, and a means for radially narrowing the cutting edge for withdrawal of the blades through the targeting guide tunnel after completion of a surgical procedure.
14. The scalpel in accordance with Claim 13, further comprising:
a. the scalpel having a barrel of a given diameter to fit within the targeting guide tunnel; and
the cutting edge of each blade contracts radially for inward passage through the targeting guide tunnel, then expands radially for making an incision, and again contracts radially for the exit passage through the targeting guide. 58
The scalpel in accordance with Claim 13, further comprising:
a. the two blades are mounted within the scalpel barrel adjacent a leading
edge of the scalpel barrel so that in a contracted position of the two blades, the cutting edge of each blade does not protrude radially beyond the scalpel handle; and
b. an actuation mechanism causes the blades to protrude radially from the
scalpel barrel, the blades are configured such that a first radially protruded position, the cutting edge sides of the blades act together as a single cutting edge that is wider than the scalpel barrel.
The scalpel in accordance with Claim 15, further comprising:
a. in a second position after rotation of the scalpel by 90 degrees, the cutting edges of the blades protrude from the barrel at 90 degrees to the first protruding position.
17. The scalpel in accordance with Claim 15, further comprising:
a. when the blades are in a protruded position such that the cutting edges
face outwardly from the scalpel barrel, the blades are configured in a
"V"-shaped double-edged cutting surface with a single point as the leading edge;
b. the actuation mechanism retracts the blades so that the non-cutting edges 59
are adjacent to the barrel of the scalpel and the cutting edges of the blades face toward a centerline of the barrel of the scalpel, the two blades formed into the shape of a letter "M" with a pointed end of each blade facing away from the barrel of the scalpel; and
c. through the actuation mechanism, the blades are caused to move over each other so that in moving from the "M" position to the "V" position, the blades cross over each other so that the cutting edges face away from each other in the "V" position, as the blades move from the "M" to the "V" position and back again, the blades create a scissors cutting mechanism.
18. The scalpel in accordance with Claim 17, further comprising:
a. a spring loaded plunger within the scalpel barrel causes the blades to move from an "M" position to a "V" position by pushing the plunger in to overcome a spring force to cause the blades to move in a first configuration and releasing the force on the plunger enables the spring force to return the plunger to its original position to cause the blades to move to a second position.
A scalpel comprising:
a. two instruments in one, a scissors and a double-edged, sharp pointed
surgical scalpel having two blades each having a sharp edge; 60
b. in a fully contracted position, the blades are an open-scissors with the
sharp blade-edges facing inwardly toward a centerline of the scaipel;
c. moving from the contracted position to a deployed position, the sharp
edges of the two blades move toward each other in a scissoring action, the blades cross over each other, so^that in the fully deployed position, the two cutting edges face away from a centerline of the scalpel, forming a sharp pointed scalpel, with sharp, side-cutting edges; and
d. as the blades move from the deployed to the contracted position and back again, the blades function as a scissors, with the cutting surfaces facing each other in one position and facing away from each other in a second position.
20. The scalpel in accordance with Claim 19, further comprising:
a. in the contracted position, the blades form the shape of the letter "M".
21. The scalpel in accordance with Claim 19, further comprising:
a. in the deployed position, the blades form the shape of the letter "V".
22. A scalpel, comprising:
a. one mobile blade configured in such a way that its narrowest dimension is the same as, or narrower than, the width of a scalpel barrel, while the widest 61
dimension of the blade is sufficiently wider than the width of the barrel to make an incision in skin;
the blade is set in such a way that it does not protrude radially outside the profile of the scalpel barrel in the contracted position; and
the blade is designed to create an incision of a given width by protruding beyond the radius of the barrel by a mechanism that rotates the blade 90 degrees so that by rotating the blade 90 degrees after passage through a targeting guide tunnel, a wider dimension protrudes radially from the sides of the barrel, and thereby presents a cutting edge that is wider than the scalpel barrel.
A surgical scalpel for making an incision in skin and a soft tissue path to bone, comprising:
a. a scalpel barrel which is generally a partial cylinder having a diameter that is the same as an interior of a targeting guide through which it is passed;
b. the barrel having a sufficient length to pass through the targeting guide, through skin, and through deep fascia down to bone, and still le ive sufficient space for a handle protruding from an opposite end ol the barrel to enable the handle to be grasped;
c. the scalpel having means for radially narrowing a cutting edge of blades of the scalpel for passage through the targeting guide, a means for restoring 62
the cutting edges of he blades to their full width after passage through the targeting guide, and a means for radially narrowing the cutting edges of the blades for withdrawal of the blades through the targeting guide tunnel; at least two blades each having a cutting edge, each blade mounted within the scalpel barrel near a leading edge of the scalpel barrel, where in the contracted position the blades do not protrude radially beyond a width of the scalpel barrel, an actuation mechanism causes the blades to protrude radially from the scalpel barrel when needed, the blades are conligured in such a way that, in the radially protruded position, they act toget er, as a single cutting edge that is wider than the scalpel barrel and form a shape of a lerter "V";
when the cutting edges of the blades of the scalpel form a sharp pointed "V", and if the scalpel is inserted straight down to the bone through the targeting guide and then withdrawn straight out, without any sideways movements, then the deepest part of the path created by the cutting edge will be a point, the terminal end of the path made in this manna- will be a triangular shape space that will have the triangular dimensions of the triangular cutting edge;
when a surgeon needs to traverse thick deep fascia in the upper thigh, a drill guide will not easily penetrate the small puncture hole made by the sharp "V" tip of the scalpel in the fascia lata, then a second blade position 63
is to use the two blades having two advancing points, which together form the shape of an "M", then the scalpel instrument is withdrawn about one quarter inch, is changed to the second blade position, and again advanced to the bone as an "M"; however even then, this incision will not oc wide enough to allow passage of the cylindrical drill guide, because the "M" portion of the incision will only be as wide as the internal diameter of the targeting guide, therefore the present invention scalpel instrument, still in the second blade position "M" configuration, is again withdrawr about one quarter inch, rotated ninety degrees and again advanced to the bone, the two "M" cuts will create a cruciate incision in the deep fascia, each limb of the two limbs of the cruciate cut will be equal to the diameter of the drill guide.
24. The scalpel in accordance with Claim 23, further comprising:
a. the two blades are mobile and can be altered in configuration from "M"
shaped to "V" shaped, and in the configuration alteration, the two blades cross each other to perform a scissors cutting action by which trie fascia lata is cut.
25. The scalpel in accordance with Claim 23, further comprising:
a. the cut made facilitates advancing a bullet-nosed drill guide through the target 64
guide, through the skin and the deep fascia, through a cruciate opening in the fascia lata and
b. the drill enables a screw to be placed into the bone and through an aligned opening in a nail guide placed within the bone.
26. A scalpel instrument, comprising:
a. two movable blades each having a cutting edge at an angle to a base of each blade and a straight non cutting edge, each blade ending in a dis":al point, a long barrel having a given length that is long enough to traverse the length of a target guide tunnel and further extend beyond skin and soft- tissue of a patient to a patient's bone;
b. the diameter of the barrel is the same as the inner diameter of the targeting guide tunnel, the barrel of the scalpel is shaped selected from the group consisting of circular cylinder, triangular, rectangular, and octagonal, as long as the outer diameter of the barrel fits within the inner diameter of the targeting guide tunnel;
c. the two blades lie one atop the other with their cutting edges facing
opposite directions so that in a retracted position the blades form a letter "M" with the cutting edges at an interior location of the two blades and in an expanded condition, the blades faun a letter "V" with the cutting edges on an exterior edge of each blade; 65
the blades are caused to move across each other by a spring-loaded plunger with a handle having a finger hold located near the proximal end of a plunger rod and having a transverse rod located at the tip of the distal end; the two movable blades are affixed to the plunger rod through a pair of slots that are identical to each other when the blades are placed fiat one over the other facing the same direction away from the barrel with the blades form a letter "M", and the slot extends at opposite angles to the direction of the plunger rod so that when the lades move along opposite slot directions, the blades form a letter 'V"; and
a transverse rod is engaged in the matching slots of the respective blades, the default position for a spring-loaded plunger is in the retraction position, and placing two fingers, such as the first finger and second finger of a hand, into finger holds so that the thumb is available to depress a cover of the spring-loaded plunger, the thumb depresses the cover and thereby depresses the spring-loaded plunger, causing the spring to compress and the plunger rod to move forward up the barrel of the shaft towards the distal end of the barrel, as the plunger rod moves forward, the transverse rod advances along the matching slots until it reaches the ends of the slots, the transverse rod has pushed both blades simultaneously outward with each blade being oriented in opposite directions, the two blades angle outwardly in and expanded condition creating a "V" formation cutting 66
surface of the scalpel, the retraction, partial or full, involves the partial or full release of the retraction mechanism, which in the preferred
embodiment entails the release of the spring-loaded plunger, wherein the plunger rod withdraws down the length of the barrel, and the traTisverse rod will correspondingly withdraw down the matching slots to engage the aligned ends of the matching slots of the blades causing the blades to move to the retracted "M" position, the action of radially retraction and expansion of one blade over the other creating a scissors cutting action to cut through thick fascia lata adjacent to bone, the barrel of the scalpel instrument is long enough to reach the bone in this position.
The scalpel in accordance with Claim 26, further comprising a method and apparatus for making precise and minimal skin and soft-tissue tunnels,
comprising:
a. an outrigger into which a locking nail is attached at a first end of the
outrigger and a targeting device is attached at a second end of th e
outrigger, a locking nail is inserted into the bone, usually through the base of the bone, the locking nail has multiple screw holes through which a screw will be affixed, however once the locking nail is inserted into the bone, the screw holes cannot be seen;
b. a targeting guide having numerous holes that align with the screw holes of the 67
locking nail, the locking nail and the targeting guide are each removably affixed to the outrigger, which, among other things, maintains the alignment of the screw holes of the locking nail and the corresponding holes of the targeting guide; and
c. once it has been determined which screw hole of the locking nail should be engaged with a screw, a targeting guide tunnel is selected which corresponds to the hole so that the targeting guide tunnel is now in position exactly where the screw hole of the locking nail is located by being in a corresponding targeting hole, and is also at the exact .ingle at which the screw will be inserted and affixed to the locking nail, and is now in position for a scalpel to create a soft-tissue tunnel, followed by insertion of the screw, and surgical closing procedures.
The scalpel and method in accordance with Claim 26, further comprising:
a. the blades of the scalpel instrument are in the "V" formation and are
advanced through the skin and soft-tissue to reach the bone, the skin incision and the soft-tissue tunnel that is created by the blade is wider than the barrel of the scalpel instrument, and is at an angle that is the exact path that a screw will follow;
b. after the blades of the scalpel instrument in the "V" formation have
reached the bone, the blades are withdrawn, the soft-tissue tunnsl ends in a 68
"V" formation matching the shape of the blades of the scalpel, it is desirous that -the soft-tissue tunnel does not end with at a point at the bone so to create a complete soft-tissue tunnel that will have access to the bone that is the width of the soft-tissue tunnel, and not merely the single point where the two blades meet the bone, the blades are moved to be ;n the "M" shape to widen the soft issue tunnel; and
c. the "M" shaped scalpel is withdrawn so that there is a soft tissue
straight-line incision, thereby allowing full access to the bone and the future placement of a screw unimpeded and without further damage to the soft-tissue.
29. The scalpel and method in accordance with Claim 28, further comprising:
a. the scalpel is removed from the targeting tunnel and the soft-tissue tunnel that ends in a straight line incision, a drill with a screw extends through the targeting tunnel and into the soft tissue tunnel, the screw is guided through the targeting tunnel and surgically inserted through the bone anc through a screw hole in a locking nail within the bone, which corresponds with the soft tissue tunnel; and
b. the locking nail remains in place in the bone and in the same
manner another screw is inserted into the bone so that at least two screws have been properly and precisely affixed at the correct 69
angles to the bone.
30. The scalpel in accordance with Claim 2, further comprising;
a. the scalpel having a barrel of a given diameter to fit within the targeting guide tunnel; and
b. the cutting edge of each blade contracts radially for inward passage through the targeting guide tunnel, then expands radially for making an incision, and again contracts radially for the exit passage through the targtjting guide.
31. The scalpel in accordance with Claim 2, further comprising:
a. the two blades are mounted within the scalpel barrel adjacent a leading
edge of the scalpel barrel so that in a contracted position of the t o blades, the cutting edge of each blade does not protrude radially beyond the scalpel handle; and
b. an actuation mechanism causes the blades to protrude radially from the
scalpel barrel, the blades are configured such that a first radiall} protruded position, the cutting edge sides of the blades act together as a single cutting edge that is wider than the scalpel barrel.
32. The scalpel in accordance with Claim 31 , further comprising: 70
when the blades are in a protruded position such that the cutting edges face outwardly from the scalpel barrel, the blades are configured in a "V"-shaped double-edged cutting surface with a single point as the leading edge;
the actuation mechanism retracts the blades so that the non-cutting edges are adjacent to the barrel of the scalpel and the cutting edges of the blades face toward a centerline of the barrel of the scalpel, the two blades formed into the shape of a letter "M" with a pointed end of each blade facing away from the barrel of the scalpel; and
through the actuation mechanism, the blades are caused to move over each other so that in moving from the "M" position to the "V" position, the blades cross over each other so that the cutting edges face away from each other in the "V" position, as the blades move from the "M" to ths "V" position and back again, the blades create a scissors cutting mec anism.
PCT/US2013/035671 2012-05-01 2013-04-08 Method and apparatus for minimally invasive skin and soft-tissue incisions WO2013172998A2 (en)

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Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13/461,460 US9089357B2 (en) 2011-07-11 2012-05-01 Multi-functional double bladed surgical tool
US13/461,460 2012-05-01

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WO2013172998A3 WO2013172998A3 (en) 2014-01-23
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US9456840B1 (en) 2016-10-04
US9089357B2 (en) 2015-07-28
EP2844153A4 (en) 2016-02-24
EP2844153A2 (en) 2015-03-11
US20130190793A1 (en) 2013-07-25
US10299822B1 (en) 2019-05-28
WO2013172998A3 (en) 2014-01-23

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