Tissue slitting methods and systems

Abstract

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

What is claimed is: 
     
         1 . A device for slitting tissue, comprising:
 a shaft configured to be coupled to a laser light source, wherein the shaft is flexible, the shaft comprising:
 a proximal end; 
 a distal end comprising a top portion and a bottom portion, wherein the distal end is tapered from the top portion to the bottom portion, wherein the bottom portion is distal to the top portion, wherein the bottom portion is biased, thereby creating a left-facing biased bottom portion and a right-facing biased bottom portion; 
 an inner lumen running from the distal end and configured to receive at least one implanted object, wherein the inner lumen is parallel to a longitudinal axis running along the inner lumen of the shaft; and 
 a plurality of optical fibers carried by the shaft and exposed at the bottom portion of the distal end of the shaft, wherein at least one of the plurality of optical fibers is exposed from the left-facing biased bottom portion and another of the plurality of optical fibers is exposed from the right-facing biased bottom portion, and wherein the plurality of optical fibers transmit light energy at an angle relative to the longitudinal axis to ablate tissue at least partially surrounding the implanted object while the implanted object is disposed in the first inner lumen. 
   
     
     
         2 . The device of  claim 1 , wherein the left-facing biased bottom portion and a right-facing biased bottom portion form a wedge. 
     
     
         3 . The device of  claim 2 , wherein the plurality of optical fibers are only exposed at the bottom portion of the distal end of the shaft. 
     
     
         4 . The device of  claim 3 , wherein at least two of the plurality of optical fibers are exposed from the left-facing biased bottom portion and another two of the plurality of optical fibers are exposed from the right-facing biased bottom portion. 
     
     
         5 . The device of  claim 2 , wherein the wedge comprises a cutting edge. 
     
     
         6 . The device of  claim 5 , wherein the plurality of optical fibers are only exposed at the bottom portion of the distal end of the shaft. 
     
     
         7 . The device of  claim 1 , wherein the plurality of optical fibers are only exposed at the bottom portion of the distal end of the shaft. 
     
     
         8 . A system for slitting tissue, comprising:
 a laser light source configured to generate light energy;   a shaft coupled to the laser light source, wherein the shaft is flexible, the shaft comprising:
 a proximal end; 
 a distal end comprising a top portion and a bottom portion, wherein the distal end is tapered from the top portion to the bottom portion, wherein the bottom portion is distal to the top portion, wherein the bottom portion is biased, thereby creating a left-facing biased bottom portion and a right-facing biased bottom portion; 
 an inner lumen running from the distal end and configured to receive at least one implanted object, wherein the inner lumen is parallel to a longitudinal axis running along the inner lumen of the shaft; and 
 a plurality of optical fibers carried by the shaft and exposed at the bottom portion of the distal end of the shaft, wherein at least one of the plurality of optical fibers is exposed from the left-facing biased bottom portion and another of the plurality of optical fibers is exposed from the right-facing biased bottom portion, and wherein the plurality of optical fibers transmit light energy at an angle relative to the longitudinal axis to ablate tissue at least partially surrounding the implanted object while the implanted object is disposed in the first inner lumen. 
   
     
     
         9 . The system of  claim 8 , wherein the laser light source is configured to output one or more wavelengths of light energy. 
     
     
         10 . The system of  claim 9 , wherein the light energy is 308 nanometers. 
     
     
         11 . The system of  claim 8 , wherein the laser light source is an XeCl excimer laser and the wavelength of light energy is 308 nanometers. 
     
     
         12 . The system of  claim 8 , wherein the left-facing biased bottom portion and a right-facing biased bottom portion form a wedge. 
     
     
         13 . The system of  claim 12 , wherein the plurality of optical fibers are only exposed at the bottom portion of the distal end of the shaft. 
     
     
         14 . The system of  claim 13 , wherein at least two of the plurality of optical fibers are exposed from the left-facing biased bottom portion and another two of the plurality of optical fibers are exposed from the right-facing biased bottom portion. 
     
     
         15 . The system of  claim 12 , wherein the wedge comprises a cutting edge. 
     
     
         16 . The system of  claim 15 , wherein the plurality of optical fibers are only exposed at the bottom portion of the distal end of the shaft. 
     
     
         17 . The system of  claim 8 , wherein the plurality of optical fibers are only exposed at the bottom portion of the distal end of the shaft. 
     
     
         18 . A device for slitting tissue, comprising:
 a shaft configured to be coupled to a laser light source, wherein the shaft is flexible, the shaft comprising:
 a proximal end; 
 a distal end comprising a top portion and a bottom portion, wherein the distal end is tapered from the top portion to the bottom portion, wherein the bottom portion is distal to the top portion; 
 an inner lumen running from the distal end and configured to receive at least one implanted object, wherein the inner lumen is parallel to a longitudinal axis running along the inner lumen of the shaft; and 
 a plurality of optical fibers carried by the shaft and exposed at only the bottom portion of the distal end of the shaft, and wherein the plurality of optical fibers transmit light energy at an angle relative to the longitudinal axis to ablate tissue at least partially surrounding the implanted object while the implanted object is disposed in the first inner lumen. 
   
     
     
         19 . The system of  claim 18 , wherein the laser light source is configured to output one or more wavelengths of light energy. 
     
     
         20 . The system of  claim 19 , wherein the light energy includes 308 nanometers.