Hand-held instruments that access interior body regions

Abstract

A first instrument having a distal end is sized and configured to penetrate tissue and a proximal end comprising a first handle assembly. A second instrument including an interior lumen is sized and configured to accept passage of the first instrument. The second instrument has a proximal end comprising a second handle assembly sized and configured to releasably interlock with the first handle assembly to form a composite instrument sized and configured to provide percutaneous access to a cancellous bone region. The second handle assembly is also sized and configured to permit controllably release by a user of the first handle assembly from the second handle assembly to allow removal of the first instrument from the interior lumen. At least one additional instrument is sized and configured for passage through the interior lumen of the second instrument upon removal of the first instrument.

1 . A system comprising 
 a first instrument having a distal end sized and configured to penetrate tissue and a proximal end comprising a first handle assembly,    a second instrument including an interior lumen sized and configured to accept passage of the first instrument, the second instrument having a proximal end comprising a second handle assembly sized and configured to releasably interlock with the first handle assembly to form a composite instrument sized and configured to provide percutaneous access to a cancellous bone region, the second handle assembly also sized and configured to permit controllably release by a user of the first handle assembly from the second handle assembly to allow removal of the first instrument from the interior lumen, and    at least one additional instrument sized and configured for passage through the interior lumen of the second instrument upon removal of the first instrument.    
     
     
         2 . A system according to  claim 1   wherein the additional instrument comprises a delivery tube sized and configured to pass through the interior lumen of the second instrument upon removal of the first instrument, the delivery tube having a proximal end including a connector for coupling the delivery tube to an injector of bone filling material to convey the bone filling material into the cancellous bone region.    
     
     
         3 . A system according to  claim 1   wherein the additional instrument comprises a third instrument sized and configured to pass through the interior lumen of the second instrument upon removal of the first instrument, the third instrument having a distal region sized and configured to treat the cancellous bone region.    
     
     
         4 . A system according to  claim 3   wherein the distal region is sized and configured to biopsy cancellous bone.    
     
     
         5 . A system according to  claim 3   wherein the distal region is sized and configured to harvest cancellous bone.    
     
     
         6 . A system according to  claim 3   wherein the distal region is sized and configured to introduce a therapeutic material.    
     
     
         7 . A system according to  claim 3   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material.    
     
     
         8 . A system according to  claim 3   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material by contacting the cancellous bone region.    
     
     
         9 . A system according to  claim 8   wherein the distal region is capable of expansion into contact with the cancellous bone region.    
     
     
         10 . A system according to  claim 8   wherein the distal region is capable of inflation into contact with the cancellous bone region.    
     
     
         11 . A system according to  claim 3   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material by creating a cavity in the cancellous bone region.    
     
     
         12 . A system according to  claim 1   wherein the distal region is sized and configured to move fractured cortical bone.    
     
     
         13 . A system according to  claim 1   wherein the second instrument comprises a cannula.    
     
     
         14 . A system comprising 
 a first instrument having a distal end sized and configured to penetrate tissue and a proximal end comprising a first handle assembly,    a second instrument including an interior lumen sized and configured to accept passage of the first instrument, the second instrument having a proximal end comprising a second handle assembly sized and configured to releasably interlock with the first handle assembly to form a composite instrument sized and configured to provide percutaneous access a cancellous bone region, the second handle assembly also sized and configured to permit controllably release by a user of the first handle assembly from the second handle assembly to allow removal of the first instrument from the interior lumen,    a third instrument sized and configured to pass through the interior lumen of the second instrument upon removal of the first instrument, the third instrument having a distal region sized and configured to treat the cancellous bone region, and    a delivery tube sized and configured to pass through the interior lumen of the second instrument upon removal of the third instrument, the delivery tube having a proximal end including a connector for coupling the delivery tube to an injector of bone filling material to convey the bone filling material into the cancellous bone region treated by the third instrument.    
     
     
         15 . A system according to  claim 14   wherein the distal region is sized and configured to biopsy cancellous bone.    
     
     
         16 . A system according to  claim 14   wherein the distal region is sized and configured to harvest cancellous bone.    
     
     
         17 . A system according to  claim 14   wherein the distal region is sized and configured to introduce a therapeutic material.    
     
     
         18 . A system according to  claim 14   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material.    
     
     
         19 . A system according to  claim 18   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material by contacting the cancellous bone region.    
     
     
         20 . A system according to  claim 19   wherein the distal region is capable of expansion into contact with the cancellous bone region.    
     
     
         21 . A system according to  claim 19   wherein the distal region is capable of inflation into contact with the cancellous bone region.    
     
     
         22 . A system according to  claim 18   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material by creating a cavity in the cancellous bone region.    
     
     
         23 . A system according to  claim 14   wherein the distal region is sized and configured to move fractured cortical bone.    
     
     
         24 . A system according to  claim 14   wherein the second instrument comprises a cannula.    
     
     
         25 . A system comprising 
 a first instrument having a distal end sized and configured to penetrate tissue and a proximal end comprising a first handle assembly,    a second instrument including an interior lumen sized and configured to accept passage of the first instrument, the second instrument having a proximal end comprising a second handle assembly sized and configured to releasably interlock with the first handle assembly to form a composite instrument sized and configured to provide percutaneous access a cancellous bone region, the second handle assembly also sized and configured to permit controllably release by a user of the first handle assembly from the second handle assembly to allow removal of the first instrument from the interior lumen,    an injector tool to inject bone filling material, and    a delivery tube sized and configured to pass through the interior lumen of the second instrument upon removal of the first instrument, the delivery tube having a proximal end including a connector for coupling the delivery tube to the injector tool to convey bone filling material into the cancellous bone region.    
     
     
         26 . A system according to  claim 25   wherein the injector tool includes a reservoir for receiving a bone filling material and an ejector sized and configured to expel the bone filling material from the reservoir.    
     
     
         27 . A system according to  claim 25   wherein the injector tool includes a syringe.    
     
     
         28 . A system according to  claim 25   wherein the bone filling material comprises bone cement.    
     
     
         29 . A system according to  claim 25   wherein the bone filling material comprises bone graft tissue.    
     
     
         30 . A system according to  claim 25   wherein the second instrument comprises a cannula.    
     
     
         31 . A system comprising 
 a first instrument having a distal end sized and configured to penetrate tissue and a proximal end comprising a first handle assembly,    a second instrument including an interior lumen sized and configured to accept passage of the first instrument, the second instrument having a proximal end comprising a second handle assembly sized and configured to releasably interlock with the first handle assembly to form a composite instrument sized and configured to provide percutaneous access a cancellous bone region, the second handle assembly also sized and configured to permit controllably release by a user of the first handle assembly from the second handle assembly to allow removal of the first instrument from the interior lumen,    a third instrument sized and configured to pass through the interior lumen of the second instrument upon removal of the first instrument, the third instrument having a distal region sized and configured to treat the cancellous bone region,    an injector tool to inject bone filling material, and    a delivery tube sized and configured to pass through the interior lumen of the second instrument upon removal of the third instrument, the delivery tube having a proximal end including a connector for coupling the delivery tube to the injector tool to convey bone filling material into the cancellous bone region treated by the third instrument.    
     
     
         32 . A system according to  claim 31   wherein the distal region is sized and configured to biopsy cancellous bone.    
     
     
         33 . A system according to  claim 31   wherein the distal region is sized and configured to harvest cancellous bone.    
     
     
         34 . A system according to  claim 31   wherein the distal region is sized and configured to introduce a therapeutic material.    
     
     
         35 . A system according to  claim 31   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material.    
     
     
         36 . A system according to  claim 35   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material by contacting the cancellous bone region.    
     
     
         37 . A system according to  claim 36   wherein the distal region is capable of expansion into contact with the cancellous bone region.    
     
     
         38 . A system according to  claim 36   wherein the distal region is capable of inflation into contact with the cancellous bone region.    
     
     
         39 . A system according to  claim 35   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material by creating a cavity in the cancellous bone region.    
     
     
         40 . A system according to  claim 31   wherein the distal region is sized and configured to move fractured cortical bone.    
     
     
         41 . A system according to  claim 31   wherein the injector tool includes a reservoir for receiving a bone filling material and an ejector sized and configured to expel the bone filling material from the reservoir.    
     
     
         42 . A system according to  claim 31   wherein the injector tool includes a syringe.    
     
     
         43 . A system according to  claim 31   wherein the bone filling material comprises bone cement.    
     
     
         44 . A system according to  claim 31   wherein the bone filling material comprises bone graft tissue.    
     
     
         45 . A system according to  claim 31   wherein the second instrument comprises a cannula.    
     
     
         46 . A method comprising 
 providing a first instrument having a distal end sized and configured to penetrate tissue and a proximal end comprising a first handle assembly,    providing a second instrument including an interior lumen sized and configured to accept passage of the first instrument, the second instrument having a proximal end comprising a second handle assembly sized and configured to releasably interlock with the first handle assembly,    forming a composite instrument by interlocking the first and second handle assemblies,    manipulating the composite handle to through tissue to provide percutaneous access to a cancellous bone region,    releasing the first handle assembly from the second handle assembly to remove the first instrument from the interior lumen,    providing an additional instrument, and    passing the additional instrument through the interior lumen of the second instrument into the cancellous bone region.    
     
     
         47 . A method according to  claim 46   wherein the additional instrument comprises a delivery tube sized and configured to pass through the interior lumen of the second instrument upon removal of the first instrument, the delivery tube having a proximal end including a connector for coupling the delivery tube to an injector of bone filling material to convey the bone filling material into the cancellous bone region.    
     
     
         48 . A method according to  claim 46   wherein the additional instrument includes a third instrument sized and configured to pass through the interior lumen of the second instrument upon removal of the first instrument, the third instrument having a distal region sized and configured to treat the cancellous bone region.    
     
     
         49 . A method according to  claim 48   wherein the distal region is sized and configured to biopsy cancellous bone.    
     
     
         50 . A method according to  claim 48   wherein the distal region is sized and configured to harvest cancellous bone.    
     
     
         51 . A method according to  claim 48   wherein the distal region is sized and configured to introduce a therapeutic material.    
     
     
         52 . A method according to  claim 48   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material.    
     
     
         53 . A method according to  claim 52   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material by contacting the cancellous bone region.    
     
     
         54 . A method according to  claim 53   wherein the distal region is capable of expansion into contact with the cancellous bone region.    
     
     
         55 . A method according to  claim 53   wherein the distal region is capable of inflation into contact with the cancellous bone region.    
     
     
         56 . A method according to  claim 52   wherein the distal region is sized and configured to modify the cancellous bone region to receive a bone filling material by creating a cavity in the cancellous bone region.    
     
     
         57 . A system according to  claim 48   wherein the distal region is sized and configured to move fractured cortical bone.    
     
     
         58 . A method according to  claim 46   further including providing a delivery tube sized and configured to pass through the interior lumen of the second instrument upon removal of the third instrument,    coupling the delivery tube to an injector of bone filling material,    conveying the bone filling material from the injector through the delivery tube and into the cancellous bone region treated by the third instrument.