Tissue Modification Devices and Methods of Using The Same

Abstract

Tissue modification devices are provided. Aspects of the devices include an elongated member having a proximal end and a distal end. The distal end of the elongated member is dimensioned to pass through a minimally invasive body opening and includes a distal end integrated visualization sensor and tissue modifier. In some instances, the devices further include an integrated articulation mechanism that imparts steerability to at least one of the visualization sensor, the tissue modifier and the distal end of the elongated member. Also provided are methods of modifying internal target tissue of a subject using the tissue modification devices.

1 . A tissue modification device comprising:
 an elongated member having a distal end dimensioned to be passed through a minimally invasive body opening, wherein the distal end comprises an integrated visualization sensor and tissue modifier.   
     
     
         2 . The tissue modification device according to  claim 1 , wherein the integrated visualization sensor comprises a lens and an integrated circuit. 
     
     
         3 . The tissue modification device according to  claim 2 , wherein the visualization sensor is a CMOS device. 
     
     
         4 . The tissue modification device according to  claim 2 , wherein the visualization sensor is a CCD device. 
     
     
         5 . The tissue modification device according to  claim 1 , wherein the device further comprises an integrated articulation mechanism that imparts steerability to at least one of the visualization sensor, the tissue modifier and the distal end of the elongated member. 
     
     
         6 . The tissue modification device according to  claim 1 , wherein the distal end of the elongate member is dimensioned to be passed through a Cambin's triangle. 
     
     
         7 . The tissue modification device according to  claim 6 , wherein the distal end of the elongate member has an outer diameter of 7.5 mm or less. 
     
     
         8 . The tissue modification device according to  claim 7 , wherein the distal end of the elongate member has an outer diameter of 7.0 mm or less. 
     
     
         9 . The tissue modification device according of  claim 8 , wherein the distal end of the elongate member has an outer diameter of 5.0 mm or less. 
     
     
         10 . The tissue modification device according to  claim 1 , wherein the distal end of the elongate member further comprises an integrated illuminator. 
     
     
         11 . The tissue modification device according to  claim 10 , wherein the illuminator is a fiber-optic illuminator. 
     
     
         12 . The tissue modification device according to  claim 10 , wherein the illuminator is a light emitting diode. 
     
     
         13 . The tissue modification device according to  claim 1 , wherein the tissue modifier comprises an electrode. 
     
     
         14 . The tissue modification device according to  claim 1 , wherein at least one of the visualization sensor and tissue modifier are moveable relative to the distal end of the elongate member. 
     
     
         15 . The tissue modification device according to  claim 1 , wherein the distal end of the elongate member further comprises an irrigator and an aspirator. 
     
     
         16 . The tissue modification device according to  claim 15 , wherein the aspirator is located proximal of the integrated visualization sensor. 
     
     
         17 . The tissue modification device according to  claim 15 , wherein the aspirator comprises a port having a cross-sectional area that is 33% or more of the cross-sectional area of the distal end of the elongate member. 
     
     
         18 . The tissue modification device according to  claim 1 , wherein the elongated member is rigid. 
     
     
         19 . The tissue modification device according to  claim 1 , wherein the tissue modification device is configured to modify an intervertebral disc tissue. 
     
     
         20 . The tissue modification device according to  claim 1 , wherein the device is configured as a disposable. 
     
     
         21 . The tissue modification device according to  claim 1 , wherein the device comprises an operating handle positioned at the proximal end. 
     
     
         22 . The tissue modification device according to  claim 21 , wherein the distal end of the elongated member is rotatable about its longitudinal axis when a significant portion of the operating handle is maintained in a fixed position. 
     
     
         23 . A system comprising:
 (a) an elongated member having a distal end dimensioned to be passed through a minimally invasive body opening, wherein the distal end comprises an integrated visualization sensor and tissue modifier; and   (b) an extracorporeal controller operatively coupled to the proximal end of the elongated member.   
     
     
         24 . The system according to  claim 23 , wherein the system further comprises an image displayer for displaying to a user images obtained by the visualization sensor. 
     
     
         25 . The system according to  claim 23 , wherein the system further comprises a minimally invasive access tube. 
     
     
         26 . A method of modifying an internal target tissue of a subject, the method comprising:
 (a) positioning distal end of a tissue modification device comprising an elongated member having a distal end dimensioned to be passed through a minimally invasive body opening, wherein the distal end comprises an integrated visualization sensor and tissue modifier in operable relation to the internal target tissue; and   (b) modifying the internal target tissue with the tissue modifier.   
     
     
         27 . The method according to  claim 26 , wherein the internal target tissue site comprises spinal tissue. 
     
     
         28 . The method according to  claim 26 , wherein the method is a method of removing nucleus pulposus tissue from an intervertebral disc.