Devices and methods for performing subcutaneous surgery

Abstract

Devices and methods for performing subcutaneous surgery in a minimally invasive manner are provided. The methods include application of reduced air pressure in a recessed area of a handpiece placed over a section of skin and drawing the section of skin and subcutaneous tissue into the recessed area. In a subsequent step a tool is inserted through a tool conduit in the handpiece and through the skin into the subcutaneous tissue, enabling the performance of the desired surgery. Common surgical procedures include dissection and ablation . The devices and methods can be directed at the treatment of skin conditions like atrophic scars, wrinkles, or other cosmetic issues, at treatments like or promoting wound healing or preventing hyperhidrosis, or can be used for creating space for various implants.

1 . (canceled) 
     
     
         2 . A handpiece for receiving tissue, comprising:
 a perimeter elevation having an inner perimeter surface, and a top, the inner perimeter surface and top cooperatively defining a recessed area, an inner side of the top defining an apposition surface facing into the recessed area; and   a conduit extending through a side of the perimeter elevation;   wherein the conduit comprises an entry hole disposed on an inner side of the conduit and facing the recessed area,
 wherein the entry hole defines a tool pivot point when a distal end of a tool is inserted through the conduit and into the recessed area so that the distal end of the tool can move laterally side to side within the recessed area, and 
   wherein the conduit widens outward toward an outer side of the perimeter elevation such that the distal end of the tool inserted through the entry hole moves in one direction when a proximal end of the tool outside the conduit moves in an opposite direction,   wherein the handpiece includes a vacuum fitting operably connected to the top of the handpiece or the perimeter elevation and configured for fluid communication with the recessed area and a vacuum pump.   
     
     
         3 . The handpiece of  claim 2 , wherein the conduit is positioned from the apposition surface such that the distal end of the tool inserted through the entry hole is between 4 mm and 20 mm from the apposition surface. 
     
     
         4 . The handpiece of  claim 2 , wherein the handpiece is configured to operably connect with a guidance track, wherein the guidance track is configured to constrain a portion of the tool in contact with the guidance track to move along a predefined path to cooperatively move the distal end of the tool within the recessed area in a plane substantially parallel to the top of the handpiece and within a region of a predetermined shape defined by the predefined path. 
     
     
         5 . The handpiece of  claim 2 , wherein the vacuum pump is configured to pull a tissue securely against the apposition surface when the recessed area is placed over the tissue. 
     
     
         6 . The handpiece of  claim 2 , wherein the handpiece further comprises an elastomeric septum. 
     
     
         7 . A handpiece for receiving tissue, comprising:
 a perimeter elevation having an inner perimeter surface, and a top, the inner perimeter surface and top cooperatively defining a recessed area, an inner side of the top defining an apposition surface facing into the recessed area; and   a conduit extending through a side of the perimeter elevation;   wherein the conduit comprises an entry hole disposed on an inner side of the conduit and facing the recessed area,
 wherein the entry hole defines a tool pivot point when a distal end of a tool is inserted through the conduit and into the recessed area so that the distal end of the tool can move laterally side to side within the recessed area, and 
   wherein the conduit widens outward toward an outer side of the perimeter elevation such that the distal end of the tool inserted through the entry hole moves in one direction when a proximal end of the tool outside the conduit moves in an opposite direction,   wherein the top of the handpiece is configured to be adjustable,   wherein a distance between the inner side of the top of the handpiece and a bottom edge of the perimeter elevation is configured to be changed to adjust a volume of the recessed area when the top is adjusted.   
     
     
         8 . The handpiece of  claim 7 , wherein the conduit is positioned from the apposition surface such that the distal end of the tool inserted through the entry hole is from the apposition surface, wherein the distal end of the tool inserted through the entry hole moves in one lateral direction when the proximal end of the tool outside the conduit moves in an opposite lateral direction. 
     
     
         9 . The handpiece of  claim 7 , wherein the handpiece is configured to operably connect with a guidance track. 
     
     
         10 . The handpiece of  claim 9 , wherein the guidance track is configured to constrain a portion of the tool in contact with the guidance track to move along a predefined path to cooperatively move the distal end of the tool within the recessed area in a plane substantially parallel to the top of the handpiece and within a region of a predetermined shape defined by the predefined path. 
     
     
         11 . The handpiece of  claim 7 , wherein the handpiece includes a vacuum fitting operably connected to the top of the handpiece or the perimeter elevation and configured for fluid communication with the recessed area and a vacuum pump. 
     
     
         12 . The handpiece of  claim 11 , wherein the vacuum pump is configured to pull a tissue securely against the apposition surface when the recessed area is placed over the tissue. 
     
     
         13 . The handpiece of  claim 7 , wherein the handpiece further comprises an elastomeric septum, wherein the elastomeric septum is configured to be pierced by the tool. 
     
     
         14 . A handpiece for receiving tissue, comprising:
 a perimeter elevation having an inner perimeter surface, and a top, the inner perimeter surface and top cooperatively defining a recessed area, an inner side of the top defining an apposition surface facing into the recessed area; and   a conduit extending through a side of the perimeter elevation;   wherein the conduit comprises an entry hole disposed on an inner side of the conduit and facing the recessed area,
 wherein the entry hole defines a tool pivot point when a distal end of a tool is inserted through the conduit and into the recessed area so that the distal end of the tool can move laterally side to side within the recessed area, and 
   wherein the conduit widens outward toward an outer side of the perimeter elevation such that the distal end of the tool inserted through the entry hole moves in one direction when a proximal end of the tool outside the conduit moves in an opposite direction,   wherein the handpiece further comprises an o-ring interposed between the top of the handpiece and a perimeter wall of the perimeter elevation.   
     
     
         15 . The handpiece of  claim 14 , wherein the distal end of the tool inserted through the entry hole moves in one lateral direction when the proximal end of the tool outside the conduit moves in an opposite lateral direction, wherein the conduit allows forward and reverse movement of the tool, and wherein the tool moves in a plane substantially parallel to the apposition surface. 
     
     
         16 . The handpiece of  claim 14 , wherein the handpiece is configured to operably connect with a guidance track. 
     
     
         17 . The handpiece of  claim 16 , wherein the guidance track is configured to constrain a portion of the tool in contact with the guidance track to move along a predefined path to cooperatively move the distal end of the tool within the recessed area in a plane substantially parallel to the top of the handpiece and within a region of a predetermined shape defined by the predefined path. 
     
     
         18 . The handpiece of  claim 14 , wherein the top of the handpiece is configured to be adjustable. 
     
     
         19 . The handpiece of  claim 14 , wherein the handpiece includes a vacuum fitting operably connected to the top of the handpiece or the perimeter elevation and configured for fluid communication with the recessed area and a vacuum pump. 
     
     
         20 . The handpiece of  claim 19 , wherein the vacuum pump is configured to pull a tissue securely against the apposition surface when the recessed area is placed over the tissue. 
     
     
         21 . The handpiece of  claim 14 , wherein the handpiece further comprises an elastomeric septum, wherein the elastomeric septum is configured to be pierced by the tool and to substantially self-seal when the tool is removed.