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Method and system for performing endoscopic surgery at locations where tissue inserts into bone
| Details |
Inventors: McNamara, Gregory; Morley, Jr., David C.; Donahue, Jr., William E.;
Assignee: Endoscopic Heel Systems, Inc. (Lowell, MA)
Primary Examiner: Rosenbaum; C. Fred
Assistant Examiner: Van Over; Perry E.
Attorney, Agent or Firm: Welsh & Katz, Ltd.
An endoscopic system and method for performing endoscopic surgery at locations where tissue inserts into bone which includes a sleeve member, obturator, cutting and excision instruments, and a marking and insertion assembly wherein the sleeve member has an expanded portal through which instrument access and improved visualization can be performed at arcuate lines of insertion of tissue into bone. The sleeve member can include a flange for engaging tissue along the line of insertion and exposing the bone and measurement means for gauging precisely the reduction or resection of bone. An alternative embodiment of the sleeve member has a non-uniform aperture with an instrument portion and a register portion providing increased space and maneuverability for instruments when operating at the portal on tissue or bone that can include the flange. Cutting instruments are provided with an extension portion to extravasate from tissue and palpitate underlying tissue. An marking and insertion assembly for use in heel surgeries to remedy plantar fasciitis and in conjunction with a lateral radiograph provides precise location of an entry incision and precise medial to lateral insertion of a guide wire forming a channel for the sleeve member. The method system also provides for minimum incision surgery in the caudal release of the plantar fascia and reduction of a spur on the os calcis. |
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DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT FIGS.
1-26, illustrate the preferred method and system of the present invention for the endoscopic release of the insertion of tissue into bone throughout the body.
The present invention is described in the environment for treatment of the painful heel syndrome which can include neuritis, myositis, faciitis and adventiteal bursiris with or without a calcaneal spur.
The endoscopic release of the planar fascia at its insertion into the os calcis and/or resection of spurs has been successful for relieving pain in the heel.
The endoscopic system 20 of the present invention includes generally a cannula or sleeve member 22, trocar or obturator 24, fasciotomy instrument 110, excision instrument 160 and a marking and insertion assembly 230.
The sleeve member 22 provides an expanded portal 44 through which multiple surgical procedures such as a fasciotomy, fasciectomy, biopsy and heel spur resection can be performed at actuate lines of insertion where tissue attaches to bone.
Throughout the following detailed description, whenever possible the same reference numerals refer to like elements.
As illustrated in FIGS.
1, 3 and 4, the sleeve member 22 of the present invention includes an elongated tube 34 with open ends 36 and 38, and slot segments 40 and 42 extending inwardly from the open ends 36 and 38, respectively.
A portal 44 is located at a mid portion of the sleeve member 22.
The portal 44 is connected to slot segments 40 and 42 by tapper portions 46 to thus extend along the length of the elongated tube 34.
The portal 44 further includes side edge portions 48 and 50 to form an access 52 to view the heel structures such as the os calcis, neurovascular structures and plantar fascia.
The access 52 allows an endoscope placed in, for example, open end 36 to form an image of these heel structures.
The access 52 also allows an instrument placed in the other open end 38 for surgical utilization on these heel structures.
The portal 44 can have width 56 determined by angle 58 so as to form an expanded view of the insertion of the plantar fascia into the os calcis and other heel structures
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