Endoscopic surgical blade and method of use thereof

Abstract

An endoscopic surgical blade having a low-profile design, with an upper cutting surface and a lower cutting surface at its distal end and having a non-cutting radiused surface at the top end of the upper cutting surface, and the upper cutting surface and lower cutting surface meet at a crotch therebetween is disclosed. The blade is part of an endoscopic knife assembly which also contains a hollow knife tube hollow that allows the insertion of an endoscope for viewing of the surgical procedure. The endoscopic knife assembly can be used for in endoscopic surgery by insertion of the assembly through a slotted cannula. A method for a performing an operative procedure on a target tissue in a subject using the endoscopic knife assembly having a low-profile blade with an upper cutting surface and a lower cutting surface is also described.

1 - 27 . (canceled) 
     
     
         28 . A method for treating trigger finger, comprising:
 establishing an entry portal at a location proximal to A1 pulley;   inserting a cannula having open proximal and distal ends and an open slot extending along the length of the cannula;   inserting an endoscope into the cannula, the endoscope comprising an endoscopic knife assembly having a low-profile blade comprising a proximate end, a distal end, an upper cutting surface and a lower cutting surface at the distal end, and a non-cutting radiused surface at a top end of the upper cutting surface, wherein the upper cutting surface and the lower cutting surface meet at a crotch therebetween;   advancing the endoscope so that the blade moves in contact with the A1 pulley through the slot;   operatively engaging the A1 pulley with the blade; and   advancing the blade through the cannula to divide the A1 pulley.   
     
     
         29 . The method of  claim 28 , wherein the step of inserting an endoscope comprising an endoscopic knife assembly is preceded by the insertion of another endoscope to visualize anatomic structures surrounding the cannula. 
     
     
         30 . The method of  claim 28 , wherein the low-profile blade further comprises a horizontal mounting surface for affixing the blade onto a knife tube to form the endoscopic knife assembly. 
     
     
         31 . The method of  claim 30 , wherein the crotch is below the plane defined by the horizontal mounting surface. 
     
     
         32 . The method of  claim 30 , wherein the crotch is above the plane defined by the horizontal mounting surface. 
     
     
         33 . The method of  claim 30 , wherein the crotch is angled downward from the proximate end of the blade towards the distal end of the blade. 
     
     
         34 . The method of  claim 28 , wherein the upper cutting surface is angled about 30-40 degrees from a horizontal plane running through the crotch. 
     
     
         35 . The method of  claim 28 , wherein the lower cutting surface is angled about 50-60 degrees from a horizontal plane running through the crotch. 
     
     
         36 . The method of  claim 28 , wherein the endoscopic knife assembly further comprises a knife tube having a proximate end, a distal end and a handle at the proximal end of the knife tube. 
     
     
         37 . The method of  claim 36 , wherein the knife tube comprises an alignment ring attached near the proximate end and one or more slots at the proximate end for the attachment of a locking assembly to the knife tube and alignment ring. 
     
     
         38 . The method of  claim 36 , wherein the blade is welded to the knife tube. 
     
     
         39 . The method of  claim 36 , wherein the endoscopic knife assembly further comprises a handle at the proximal end of the knife tube. 
     
     
         40 . The method of  claim 36 , wherein the knife tube comprises an alignment ring attached near the proximate end and one or more slots at the proximate end for the attachment of a locking assembly to the knife tube and alignment ring. 
     
     
         41 . The method of  claim 28 , wherein the cannula has an inner diameter of between about 2.4 mm and about 3.0 mm. 
     
     
         42 . The method of  claim 28 , wherein the cannula has an inner diameter of between about 3.7 mm and about 4.3 mm. 
     
     
         43 . The method of  claim 28 , further comprising the step of inserting an elevator through the entry portal to establish an opening in the underlying tissue between the entry portal and the A1 pulley. 
     
     
         44 . A method for performing an endoscopic procedure on a target tissue, comprising:
 establishing an entry portal at a location proximal to the target tissue;   inserting a cannula having open proximal and distal ends, a central lumen and an open slot extending along the length of the cannula;   inserting an endoscope into the cannula, the endoscope comprising an endoscopic knife assembly having a low-profile blade comprising a proximate end, a distal end, an upper cutting surface and a lower cutting surface at the distal end, and a non-cutting radiused surface at the top end of the upper cutting surface, wherein the upper cutting surface and the lower cutting surface meet at a crotch therebetween;   advancing the endoscope so that the blade moves in contact with the target tissue through the slot;   operatively engaging the target tissue with the blade; and   advancing the blade through the cannula to divide the target tissue.   
     
     
         45 . The method of  claim 44 , further comprising the step of inserting an elevator through the entry portal to establish an opening in the underlying tissue between the entry portal and the target tissue. 
     
     
         46 . The method of  claim 45 , wherein the step of inserting an endoscope comprising an endoscopic knife assembly is preceded by the insertion of another endoscope to visualize anatomic structures surrounding the cannula. 
     
     
         47 . The method of  claim 44 , wherein the central lumen of the cannula further comprises an obturator, wherein the obturator is withdrawn following insertion of the cannula.