Rotatable sphincterotome/papillotome and method of use

Claim 1

A sphincterotome device used in conjunction with an endoscope for cutting a patient's sphincter, the device comprising: a. an elongated tubular member having a proximal end and a distal end, and being sized to be received in a lumen of the endoscope; b. a cutter member having a cutting edge located along said distal end of said tubular member and positioned generally longitudinally with respect to said tubular member, wherein the cutting edge is movable in a cutting plane to cut the patient's sphincter, the cutter member being connected to a conductor disposed in said tubular member; c. a fitting member having a distal end, a proximal end, and at least one lumen therein extending from the distal end to the proximal end, the distal end attached to said proximal end of said tubular member; d. a rigid rotatable housing of a predetermined length having a proximal end, a distal end and a longitudinal slot formed between the proximal and distal ends, the proximal end having a channel opening therein and extending into the longitudinal slot, the rotatable housing further having a thumb receiving member affixed to the distal end; e. a ratchet mechanism attached between said rotatable housing and said fitting member, and having a distal connecting end connected to said proximal end of said fitting member, a proximal end rotationally abutting against said proximal end of said rotatable housing, and a hollow pivotable post permanently affixed to the proximal end of the ratchet mechanism, the hollow pivotable post inserted into said channel opening at said proximal end of said rotatable housing so that the hollow pivotable post is rotatably secured within said channel opening at said proximal end of said rotatable housing; f. a circular rod movably disposed in said at least one lumen of said fitting member and having a distal end extending out from said distal end of said fitting member and connected to said conductor, and a proximal end exiting out from said hollow pivotable post; g. a slidable member including a slide block fitted into said longitudinal slot and a pair of extending finger receiving members extending oppositely and transversely from the slide block, the walls of said longitudinal slot constraining the slide block to longitudinal movement between said proximal and distal ends of said rotatable housing with one longitudinally extending channel formed in the slide block for receiving and securing said proximal end of said circular rod therein, where holding said ratchet mechanism and rotating said rotatable housing can orient said cutting edge of said cutter member into a correct cutting position for cutting the patient's sphincter; and h. at least one cylindrical tube affixed within said tubular member and located adjacent to said distal end for stabilizing and supporting said cutter member.

Claim 35

A method of surgically cutting a patient's sphincter, the method comprising the steps of: a. positioning an endoscope near the patient's sphincter to allow viewing of the sphincter; b. providing a sphincterotome device having a tubular member with a proximal end and a distal end; c. inserting said distal end of said tubular member out of an opening of said endoscope and into engagement with the patient's sphincter; d. longitudinally positioning a cutter member which has a cutting edge located along said distal end of said tubular member, wherein the cutting edge is movable in a cutting plane to cut the patient's sphincter, and connecting the cutter member to a conductor disposed in said tubular member; e. providing a rotatable housing means having a longitudinal slot formed therein; f. attaching a ratchet mechanism between said rotatable housing means and said proximal end of said tubular member, and rotatably securing a pivotable post to said rotatable housing means; g. disposing a rod in said ratchet mechanism and connecting one end of the rod to said conductor; h. slidably connecting a slidable member in said longitudinal slot to move in a longitudinal movement and providing means for receiving and securing the other end of said rod therein; i. holding said ratchet mechanism and rotating said rotatable housing means which orients said cutting edge of said cutter member into a correct cutting position for cutting the patient's sphincter; and j. energizing said conductor with said cutter member with said cutting edge in said cutting plane to cut the sphincter radially outward of a center of the sphincter.

Claim 36

A method of surgically cutting a patient's sphincter, the method comprising the steps of: a. positioning an endoscope near the patient's sphincter to allow viewing of the sphincter; b. providing a sphincterotome device having a tubular member with a proximal end and a distal end; c. inserting said distal end of said tubular member out of an opening of said endoscope and into engagement with the patient's sphincter; d. longitudinally positioning a cutter member which has a cutting edge located along said distal end of said tubular member, wherein the cutting edge is movable in a cutting plane to cut the patient's sphincter, and connecting the cutter member to a conductor disposed in said tubular member; e. providing a rotatable housing means having a longitudinal slot formed therein; f. attaching a ratchet mechanism between said rotatable housing means and said proximal end of said tubular member, and rotatably securing a pivotable post to said rotatable housing means; g. disposing a rod in said ratchet mechanism and connecting one end of the rod to said conductor; h. slidably connecting a slidable member in said longitudinal slot to move in a longitudinal movement and providing means for receiving and securing the other end of said rod therein; i. holding said ratchet mechanism and rotating said rotatable housing means which orients said cutting edge of said cutter member into a correct cutting position for cutting the patient's sphincter; and j. energizing said conductor with said cutter member with said cutting edge in said cutting plane to cut the sphincter radially outward of a center of the sphincter.

Claim 42

A method of surgically cutting a patient's muscle, the method comprising the steps of: a. positioning an endoscope near the patient's muscle to allow viewing of the muscle; b. providing a papillotome having a tubular member; c. inserting said tubular member out of an opening of said endoscope and into engagement with the muscle; d. positioning a cutter member which has a cutting edge along a respective end of said tubular member, wherein the cutting edge is movable in a cutting plane to cut the patient's muscle; e. attaching a ratchet mechanism to said respective end of said tubular member; f. disposing a rod in said ratchet mechanism and connecting one end thereof to said cutter member; g. holding said ratchet mechanism and rotating said rod which orients said cutting edge of said cutter member into a correct cutting position for cutting the patient's muscle; and h. energizing said cutter member with said cutting edge in said cutting plane to cut the muscle radially outward of a center of the muscle.

Claim 43

A method of surgically cutting a patient's muscle, the method comprising the steps of: a. positioning an endoscope near the patient's muscle to allow viewing of the muscle; b. providing a papillotome having a tubular member; c. inserting said tubular member out of an opening of said endoscope and into engagement with the muscle; d. positioning a cutter member which has a cutting edge along a respective end of said tubular member, wherein the cutting edge is movable in a cutting plane to cut the patient's muscle; e. attaching a ratchet mechanism to said respective end of said tubular member; f. disposing a rod in said ratchet mechanism and connecting one end thereof to said cutter member; g. holding said ratchet mechanism and rotating said rod which orients said cutting edge of said cutter member into a correct cutting position for cutting the patient's muscle; and h. energizing said cutter member with said cutting edge in said cutting plane to cut the muscle radially outward of a center of the muscle.