Tissue incision device and method

Abstract

A minimally invasive tissue incision system for creating joint capsulotomies and releasing/incising various tendon and fibrous band structures. The system contains a penetrating needle which is retractable so as to expose a cutting element, and which may be used as a penetrating needle to pierce the skin and other soft tissue structures. The cutting element provided within the penetrating needle may be used to incise subsequent tissue structures after the initial penetration. The system facilitates such procedures by providing the cutting element with the confines of the needle which provides safe introduction of the cutting element directly to the site via the needle.

1 . A method of incising tissue in medical procedure comprising:
 inserting a needle through the skin and subcutaneous tissue layers of a human or animal,   positioning the needle tip near a secondary tissue structure to be incised,   retracting the needle to expose a cutting element, and   manipulating the cutting element to incise the tissue structure.   
     
     
         2 . The method of  claim 1  where in the incised tissue structure is a joint capsule. 
     
     
         3 . The method of  claim 1  wherein the incised tissue structure is a ligament or fibrous band of tissue. 
     
     
         4 . The method of  claim 1  wherein the initial needle penetration does not require a skin incision with another instrument. 
     
     
         5 . The method of  claim 1  wherein the retraction of the needle utilizes a spring element. 
     
     
         6 . The method of  claim 1 , wherein the cutting element is slidably received within the needle, and retracting the needle comprises movement of the needle proximally relative to the cutting element. 
     
     
         7 .- 11 . (canceled) 
     
     
         12 . A device for incising tissue in the human body, comprising:
 a tissue-penetrating needle, the needle comprising a distal end, and a lumen extending along a length of the needle,   a cutting element slidingly received within the lumen needle, and   a mechanism for moving the needle relative to the cutting element.   
     
     
         13 . The device of  claim 12  wherein the cutting element is arranged such that it extends orthogonally to the axis of the needle. 
     
     
         14 . The device of  claim 12  wherein the cutting element has multiple cutting edges. 
     
     
         15 . The device of  claim 12  wherein the cutting element has serrations. 
     
     
         16 . The device of  claim 12  wherein the needle moves linearly along the length of an axis of the cutting element. 
     
     
         17 . The device of  claim 12  wherein the needle moves rotationally relative to the cutting element. 
     
     
         18 . The device of  claim 12  wherein the cutting element is mounted to a stylet. 
     
     
         19 . The device of  claim 18  wherein the stylet is designed to occlude the lumen of the needle. 
     
     
         20 . The device of  claim 12  further comprising an injector for injecting fluids through the lumen of the needle. 
     
     
         21 . The device of  claim 12  further comprising an electrosurgical generator connected to the device. 
     
     
         22 . The device of  claim 12  further comprising a nerve stimulation generator and monitoring device connected to the needle. 
     
     
         23 .- 28 . (canceled)