WO2022109224A1

WO2022109224A1 - Flexible slotted cannula and methods for use

Info

Publication number: WO2022109224A1
Application number: PCT/US2021/060020
Authority: WO
Inventors: Nathan SKELLEY
Original assignee: Sanford Health
Current assignee: Sanford Health
Priority date: 2020-11-20
Filing date: 2021-11-19
Publication date: 2022-05-27
Anticipated expiration: 2023-05-20

Abstract

The present disclosure provides a device including a first segment having a first length. The first segment has a first side and a second side opposite the first side. The device also includes a second segment having a second length. The second segment has a first side and a second side opposite the first side. The first segment is directly coupled to the second segment such that the first segment extends away from the second side of the second segment. The second segment includes a slot recessed in the first side of the second segment.

Description

Flexible Slotted Cannula and Methods for Use

Related Applications

[1] This application claims the benefit of priority to U.S. Provisional Application No.

63/116,356 entitled “Flexible Slotted Cannula and Methods for Use,” filed on November 20,

2020, the contents of which are hereby incorporated by reference in their entirety.

Background

[2] Surgical procedures have developed rapidly in the last hundred years, and new technologies have improved minimally invasive surgical approaches. Arthroscopy is a surgical procedure using small cameras and instruments to enter the body, which has allowed surgeons to perform complex and large-scale procedures through very small portal incisions of approximately 5 mm to 12 mm in size.

[3] Surgical cannulas have been developed to facilitate access to certain tissue planes and joint locations during these arthroscopic procedures. These surgical cannulas are designed to maintain arthroscopy fluid and allow instruments to pass easily into the body. Some surgical cannulas are made of rigid metallic or plastic materials and others are composed of flexible plastic materials. Most existing surgical cannulas consist of a tube or channel for instruments to pass through such that the cannula wraps around instruments completely in 360 degrees.

These cannulas do not typically expand during the course of a procedure to allow for tissue swelling from the arthroscopy fluid.

[4] Slotted cannulas or sleds have been developed as an alternative to these circular cannulas and are especially useful for longer working lengths, such as hip arthroscopy, but can be used in any surgical portal. These slotted cannulas allow instruments to pass into the body using the sled as a guide to maintain the tissue trajectory. The sled is eventually removed to allow the instruments to be used but must be replaced to allow switching instruments and protecting that tissue trajectory path. These sleds do not wrap around the instruments completely which allows for greater motion once the instruments are introduced into the body and the sled is removed. A groove or slot in the side helps guide the instrument into the body. However, in such an arrangement, the sled must constantly be introduced and removed before a surgical instrument can be removed or introduced into the joint. This process allows for extra steps and losing the trajectory or path into the joint or tissue plane.

This can result in increased trauma to gain access to the joint. Alternatively, in more complex joints such as the hip, fluoroscopy x-ray exposure may be needed to gain access to the joint again. It also commonly requires a surgical assistant to help place the sled each time. Leaving a large rigid metallic sled in place can also create a large opening in the portal that facilitates fluid extravasation leading to excess fluid in the surgical fluid and pressure control issues during the arthroscopy procedure.

Summary

[5] The present disclosure provides a device that acts as a flexible slotted cannula that facilitates introducing instruments into the body during surgical procedures. The device is initially deployed into the joint and secured with a hooked or paddle end so that the device can remain in the joint during the procedure. A delivery mechanism can be used to straighten the device during placement. When the delivery mechanism is retracted, the top and bottom portions of the device may bend back to shape and apply pressure to the outer and inner portions of the joint, respectively, to clamp the device in place, while remaining out of the way during the arthroscopic procedure.

[6] Thus, in a first aspect, the present invention provides a device comprising: (a) a first segment having a first length, wherein the first segment has a first side and a second side opposite the first side, and (b) a second segment having a second length, wherein the second segment has a first side and a second side opposite the first side, wherein the first segment is directly coupled to the second segment such that the first segment extends away from the second side of the second segment, and wherein the second segment includes a slot recessed in the first side of the second segment.

[7] In a second aspect, the present invention provides a system comprising: (a) the device of the first aspect, and (b) a delivery mechanism configured to transition the first segment of the device from a first position in which a longitudinal axis of the first segment is substantially aligned with a longitudinal axis of the second segment to a second position in which the longitudinal axis of the first segment has a non-zero angle with respect to the longitudinal axis of the second segment.

[8] In a third aspect, the present disclosure provides a method comprising: (a) forming an incision at a target anatomy, (b) inserting the first segment of the device of the first aspect into the incision at the target anatomy, wherein, during insertion, the first segment is in a first position in which a longitudinal axis of the first segment is substantially aligned with a longitudinal axis of the second segment, and (c) after the first segment is positioned into the incision, transitioning the first segment to a second position in which the longitudinal axis of the first segment has a non-zero angle with respect to the longitudinal axis of the second segment.

[9] These as well as other aspects, advantages, and alternatives, will become apparent to those of ordinary' skill in the art by reading the following detailed description, with reference where appropriate to the accompanying drawings, to quickly navigate narrow vasculature of the brain and quickly address strokes.

Brief Description of the Drawings

[10] Figure 1 illustrates a perspective view of a device, according to an example embodiment. [11] Figure 2 illustrates a perspective view of another device, according to an example embodiment.

[12] Figure 3 illustrates the device of Figure 1 temporarily coupled to a rigid member, according to an example embodiment.

[13] Figure 4A the device of Figure 2 temporarily coupled to a rigid member, according to an example embodiment.

[14] Figure 4B illustrates the device of Figure 2 temporarily coupled to a rigid member in a first position, according to an example embodiment

[15] Figure 5A illustrates a guidewire positioned through a rigid member, according to an example embodiment.

[16] Figure 5B illustrates the device of Figure 1 temporarily coupled to the rigid member of Figure 5A, according to an example embodiment.

[17] Figure 6A illustrates a guidewire positioned through a rigid member, according to an example embodiment.

[18] Figure 6B illustrates the device of Figure 2 temporarily coupled to the rigid member of Figure 6A, according to an example embodiment.

[19] Figure 7 A illustrates a first segment of the device of Figure 1 positioned in a first position with respect to a delivery mechanism, according to an example embodiment.

[20] Figure 7B illustrates the first segment of the device of Figure 1 transitioning from the first position to a second position as the plunger of the delivery mechanism is pushed forward, according to an example embodiment.

[21] Figure 7C illustrates the first segment of the device of Figure 1 in the second position, according to an example embodiment.

[22] Figure 8 illustrates another delivery mechanism, according to an example embodiment. [23] Figure 9 illustrates another delivery mechanism, according to an example embodiment.

[24] Figure 10 is a block diagram illustrating an example method, according to an example embodiment.

Detailed Description

[25] Exemplary devices and methods are described herein. It should be understood that the word “exemplary-” is used herein to mean “serving as an example, instance, or illustration.” Any embodiment or feature described herein as “exemplary'” is not necessarily to be construed as preferred or advantageous over other embodiments or features. The exemplary embodiments described herein are not meant to be limiting. One of ordinary skill in the art will readily understand that certain aspects of the disclosed systems and methods can be arranged and combined in a wide variety of different configurations, all of which are contemplated herein.

[26] Furthermore, the particular arrangements shown in the Figures should not be viewed as limiting. It should be understood that other embodiments may include more or less of each element shown in a given Figure. Further, some of the illustrated elements may be combined or omitted. Yet further, an exemplary embodiment may include elements that are not illustrated in the Figures.

[27] As used herein, with respect to measurements, “about” means +/- 5%.

[28] As used herein, “coupled” means associated directly as well as indirectly. For example, a member A may be directly associated with a member B, or may be indirectly associated therewith, e.g., via another member C. It will be understood that not all relationships among the various disclosed elements are necessarily represented.

[29] Unless otherwise indicated, the terms “first,” "second,” etc. are used herein merely as labels, and are not intended to impose ordinal, positional, or hierarchical requirements on the items to which these terms refer. Moreover, reference to, e.g., a

“second” item does not require or preclude the existence of, e.g., a “first” or lower-numbered item, and/or, e.g., a “third” or higher-numbered item.

[30] Reference herein to “one embodiment” or “one example” means that one or more feature, structure, or characteristic described in connection with the example is included in at least one implementation. The phrases “one embodiment” or “one example” in various places in the specification may or may not be referring to the same example.

[31] As used herein, a system, apparatus, device, structure, article, element, component, or hardware “configured to” perform a specified function is indeed capable of performing the specified function without any alteration, rather than merely having potential to perform the specified function after further modification. In other words, the system, apparatus, structure, article, element, component, or hardware “configured to” perform a specified function is specifically selected, created, implemented, utilized, programmed. and/or designed for the purpose of performing the specified function. As used herein,

‘configured to” denotes existing characteristics of a system, apparatus, structure, article, element, component, or hardware which enable the system, apparatus, structure, article, element, component, or hardware to perform the specified function without further modification. For purposes of this disclosure, a system, apparatus, structure, article, element, component, or hardware described as being “configured to” perform a particular function may additionally or alternatively be described as being “adapted to” and/or as being

“operative to” perform that function.

[32] The present disclosure provides a flexible slotted cannula that facilitates introducing instruments into the body during surgical procedures. The flexible slotted cannula is initially deployed into a joint of a patient, and may be secured with a hooked or paddle end. This prevents needing to take the cannula in-and-out during the procedure. The flexible slotted cannula may be manufactured in different lengths, but the flexible design allows it to gradually expand during the fluid and tissue swelling associated with the surgical procedure. The flexible slotted cannula device described herein allows instruments to enter the joint without traumatizing the tissue or making new paths through soft tissue planes each time an instrument or camera is introduced into the body. The surgeon is also not limited by the circumference of the cannula, since the device includes a slot that is not enclosed. The flexible design prevents tenting or opening up the tissue portal allowing excessive fluid to be expressed from the arthroscopy procedure. The device described herein decreases extra steps in the surgical theater and helps eliminate multiple paths through surgical portals that can increase swelling and lead to “tissue bridges,” which can greatly complicate surgical procedures.

[33] With reference to the Figures, Figure 1 illustrates an example device 100 including a first segment 102 having a first length LI. The first segment 102 has a first side

104 and a second side 106 opposite the first side 104. The device 100 further includes a second segment 108 having a second length L2. The second segment 108 has a first side 110 and a second side 112 opposite the first side 110. The first segment 102 is directly coupled to the second segment 108 such that the first segment 102 extends away from the second side

112 of the second segment 108. The second segment 108 includes a slot 114 recessed in the first side 110 of the second segment 108. The slot 114 enables the insertion and removal of instruments to and from the target anatomy without traumatizing the tissue or making new paths through soft tissue planes each time an instrument or camera is introduced into the body. In one example, the slot 114 extends to the first segment 102 such that the slot 114 is recessed in the first side 104 of the first segment 102. In one example, the first segment 102 and the second segment 108 are formed unitarily. [34] As shown in Figure 1, in one example the device 100 further includes a third segment 116 having a third length L3. The third segment 116 has a first side 118 and a second side 120 opposite the first side 118. The third segment 116 is directly coupled to the second segment 108 such that the third segment 116 extends away fiom the second side 112 of the second segment 108. In one example, the slot 114 extends to the third segment 116 such that the slot 114 is recessed in the first side 118 of the third segment 116. In a further example, the first segment 102, the second segment 108, and the third segment 116 are formed unitarily. As shown in Figure 1, the second side 106 of the first segment 102 and the second side 112 of the second segment 108 define a first angle Al, and the second side 120 of the third segment 116 and the second side 112 of the second segment 108 define a second angle A2. In one example, the first angle Al is equal to the second angle A2. In another example, the first angle Al is greater than the second angle A2. Such an arrangement may help to ensure the device 100 is secured within the joint when in use by pinching an interior of the tissue of the target anatomy with the first segment 102. In another example, the first angle Al is less than the second angle A2. Such an arrangement may help to ensure the device 100 is secured within the joint when in use by pinching the tissue of the target anatomy between the first segment 102 and the third segment 116 of the device 100. As such, the second angle A2 may cause the third segment 116 of the device 100 to contact an exterior of the target anatomy when in use. In one specific example, the first angle Al ranges fiom about 30 degrees to about 100 degrees, and the second angle A2 ranges fiom about 10 degrees to about 120 degrees. Other angles are possible as well.

[35] In one example, as shown in Figure 1 , the second side 106 of the first segment 102 and the second side 112 of the second segment 108 may define a first radius of curvature, and the second side 120 of the third segment 116 and the second side 112 of the second segment

108 define a second radius of curvature. Such an arrangement provides a smooth and atraumatic transition between the first segment 102 and the second segment 108, and further between the second segment 108 and the third segment 116. In one example, first radius of curvature is equal to the second radius of curvature. In another example, the first radius of curvature is greater than the second radius of curvature. In yet another example, the first radius of curvature is less than the second radius of curvature.

[36] In one example, the first segment 102, the second segment 108, and the third segment 116 each comprise the same material. In another example, the first segment 102 and the second segment 108 each comprise a first material, and the third segment 116 comprises a second material that is different than the first material. In one such example, the second material comprises a more rigid material than the first material. Such an embodiment may provide the pliability and flexibility needed in the first segment 102 and second segment 108, while providing additional stiffness for the third segment 116.

[37] In one example, the first length LI, the second length L2, and the third length L2 are equal. In another example, as shown in Figure 1, the second length L2 is greater than the first length LI, and the third length L3 is greater than the first length LI but less than the second length L2. Such an arrangement of the third length L3 enables a medical professional to grab and manipulate the device 100 by handling the third segment 116, and eventually remove the device 100 at the end of the procedure by pulling the third segment 116 in a direction away from the target anatomy. In one particular example, the first length LI ranges from about 0.5 cm to about 2.5 cm, the second length L2 ranges from about 0.5 cm to about

20 cm, and the third length L3 ranges from about 0.5 cm to about 4.5 cm.

[38] Figure 2 illustrates another embodiment of the device 100. As shown in Figure 2, the device 100 may include a channel 122 having a first end 124 coupled to the first side 110 of the second segment 108 such that the slot 114 and the channel 122 are aligned, and the channel 122 further includes a second end 126 extending away fiom the second segment 108. In one example, as shown in Figure 2, the first end 124 of the channel 122 has a first width that matches a width of the slot 114, and the second end 126 of the channel 122 has a second width that is greater than the first width. In one particular example, a ratio of second width at the second end 126 of the channel 122 to the first width at the first end 124 of the channel

122 is between about 2: 1 and about 5:1. In one example, as shown in Figure 2, the channel

122 is a semi-circular funnel shape. The channel 122 may be beneficial to provide a wider entrance for instruments to enter the joint without traumatizing the tissue or making new paths through soft tissue planes each time an instrument or camera is introduced into the body.

[39] The channel 122 and/or the slot 114 may provide a location into which a stopper plug can be placed at the incision if fluid is extravasating when an instrument is not positioned in the device 100. Such a stopper plug could be used with the device 100 to stop fluid from coming out of an unused portal during a surgical procedure. In one example, the stopper plug may be cannulated. In another example, if the operator wanted to modulate or lessen (instead of stopping) fluid extravasation, a diaphragm cannula or transport cannula may be positioned in the channel 122 and/or the slot 114.

[40] In one example, as shown in Figure 2, a longitudinal axis of the channel 122 is substantially parallel to a longitudinal axis of the second segment 108. In another example, the longitudinal axis of the channel 122 is at a non-zero angle relative to the longitudinal axis of the second segment 108. In one example, the non-zero angle between the longitudinal axis of the channel 122 and the longitudinal axis of the second segment 108 ranges from about 5 degrees to about 45 degrees, from about 5 degrees to about 40 degrees, from about 5 degrees to about 35 degrees, from about 5 degrees to about 30 degrees, from about 5 degrees to about

25 degrees, from about 5 degrees to about 20 degrees, from about 5 degrees to about 15 degrees, from about 5 degrees to about 10 degrees. In another example, the non-zero angle between the longitudinal axis of the channel 122 and the longitudinal axis of the second segment 108 is about 5 degrees, about 10 degrees, about 15 degrees, about 20 degrees, about

25 degrees, about 30 degrees, about 35 degrees, about 40 degrees, or about 45 degrees. Other angles are possible as well.

[41] In one example, as shown in Figures 1 and 2, the device 100 further includes an indicator 128 positioned between the second side 106 of the first segment 102 and the second side 112 of the second segment 108. The indicator 128 may comprise a notch, line, or reference mark at the inner bend between the second side 106 of the first segment 102 and the second side 112 of the second segment 108 and/or at the outer bend between the first side 104 of the first segment 102 and the first side 110 of the second segment 108. The indicator 128 may help with placement of the device 100 when in use. In another example, the indicator

128 may provide an indication to the medical profession (via a camera positioned in the body of the patient) that the device 100 is past the inner bend between the second side 106 of the first segment 102 and the second side 112 of the second segment 108, and that the device can be deployed. In particular, the device 100 is deployed by transitioning from a first position in which a longitudinal axis of the first segment 102 is substantially aligned with a longitudinal axis of the second segment 108 to a second position in which the longitudinal axis of the first segment 102 has a non-zero angle with respect to the longitudinal axis of the second segment

108. This transition occurs due to the material property of the device 100, which causes the device 100 to return to its original shape when no outside forces are applied to the device

100.

[42] In one embodiment, the present disclosure provides a system 190 including the device 100 according to any of the embodiments discussed above, and a deliver}' mechanism

130. The delivery mechanism 130 is configured to deploy the device 100 by transitioning the first segment 102 of the device 100 from the first position to the second position, as discussed above. The delivery' mechanism 130 may take a variety of forms. In one example, the delivery mechanism 130 is disposable. In another example, the delivery mechanism 130 may include one or more measurement markings positioned thereon. Such measurement markings may provide a way to determine which of a variety of sizes of the device 100 should be used for a particular procedure.

[43] With reference to Figures 4A-6B, the delivery mechanism 130 may comprise a rigid member 132 having a first end 134 and a second end 136 opposite the first end 134.

The first end 134 of the rigid member 132 may comprise an atraumatic tip to ease with placement of the device 100 to the target anatomy. The device 100 may be temporarily coupled to the first end 134 of the rigid member 132 in the first position, and the device is decoupled from the first end 134 of the rigid member 132 in the second position. In one particular embodiment, as shown in Figure 3, the device 100 is temporarily coupled to the first end 134 of the rigid member 132 via a suture 138 in the first position, and the device 100 is decoupled from the first end 134 of the rigid member 132 by cutting the suture 138 to thereby transition the first segment 102 of the device 100 from the first position to the second position.

[44] In another particular embodiment, as shown in Figures 4A-6B, the first end 134 of the rigid member 132 includes a first hook 140 configured to removably secure the first segment 102 of the device 100 to the first end 134 of the rigid member 132. Figure 4A illustrates the first hook 140 at the first end 134 of the rigid member 132 removably secured to the first segment 102 of the device 100. Figure 4B illustrates the first segment 102 of the device 100 in the first position. Once the first segment 102 of the device 100 is positioned in the target anatomy, the rigid member 132 may be rotated to remove the first segment 102 of the device 100 from the first hook 140, thereby deploying the device 100 in the target anatomy. [45] As shown in Figures 5A-5B, the rigid member 132 may include a through-hole that extends from the first end 134 to the second end 136 for positioning of a guidewire 142 therethrough (e.g., the rigid member 132 may be cannulated). Figure 5 A illustrates the guidewire 142 positioned through the through-hole of the cannulated delivery' mechanism

130, and Figure 5B illustrates the first hook 140 at the first end 134 of the rigid member 132 removably secured to the first segment 102 of the device 100 in the first position.

[46] As shown in Figures 6A-6B, the rigid member 132 further comprises a second hook 144 arranged perpendicular to the first hook 140 and positioned between the first end

134 and the second end 136 of the rigid member 132. The second hook 144 may help to keep the first segment 102 and the second segment 108 of device 100 substantially flat against the rigid member 132 prior to deployment. As discussed above, the device 100 is decoupled from the first end 134 of the rigid member 132 by a rotation of the rigid member 132 to thereby transition the first segment 102 of the device 100 fiom the first position to the second position.

[47] In another example, as shown in Figures 7A-7C, the delivery mechanism 130 comprises a sheath 146 configured to at least partially surround the first segment 102 in the first position, and the sheath 146 is retractable, via a plunger 148 as a non-limiting example, to transition the first segment 102 of the device 100 from the first position to the second position. Figure 7 A illustrates the first segment 102 in the first position, Figure 7B illustrates the first segment 102 transitioning fiom the first position to the second position as the plunger

148 is pushed forward, and Figure 7C illustrates the first segment 102 in the second position.

[48] In another example, as shown in Figure 8, the delivery mechanism 130 comprises a cannulated housing 150 that encloses the device 100 in the first position, and a plunger 148 that deploys the device 100 out of the cannulated housing 150 to deploy the device 100 by transitioning the first segment 102 of the device 100 from the first position to the second. [49] Figure 9 illustrates another example embodiment of a delivery mechanism 130.

As shown in Figure 9, the delivery mechanism 130 may include a groove 152 into which the device 100 is positioned. The groove 152 partially surrounds the first segment 102 to hold the first segment 102 of the device 100 in the first position during positioning of the device

100. The delivery' mechanism 130 may include a tapered portion 154 adjacent to a handle

156, to enable easy loading of the device 100 into the groove 152 of the delivery mechanism

130. As shown in Figure 9, the delivery mechanism 130 may include a rounded atraumatic tip 158. Inside of the groove 152 adjacent the rounded atraumatic tip 158, the delivery mechanism 130 may include a bevel 160. The bevel 160 may have an angle ranging from about 35 degrees to about 75 degrees with respect to the bottom surface of the groove 152, and preferably the bevel 160 may be about 60 degrees. Once the delivery mechanism 130 is positioned in the target anatomy, the device 100 can be pushed towards the bevel 160 until the first segment 102 of the device 100 contacts the bevel 160. This contact with the bevel

160 enables the first segment 102 of the device 100 to slip out of the groove 152 to thereby transition the first segment 102 of the device 100 from the first position to the second position.

[50] Figure 10 is a block diagram of an example method. Method 200 shown in Figure

10 presents an embodiment of a method that could be used by the devices and systems of

Figures 1-9, as an example. Method 200 may include one or more operations, functions, or actions as illustrated by one or more of blocks 202-206. Although the blocks are illustrated in a sequential order, these blocks may also be performed in parallel, and/or in a different order than those described herein. Also, the various blocks may' be combined into fewer blocks, divided into additional blocks, and/or removed based upon the desired implementation. [51] Initially, at block 202, the method 200 includes forming an incision at a target anatomy. The target anatomy may comprise one of a knee, a shoulder, or a hip. Other target anatomies are possible as well. At block 204, the method 200 includes inserting the first segment 102 of the device 100 of any one of the embodiments described above into the incision at the target anatomy, wherein, during insertion, the first segment 102 is in a first position in which a longitudinal axis of the first segment 102 is substantially aligned with a longitudinal axis of the second segment 108. At block 206, the method 200 includes, after the first segment 102 is positioned into the incision, transitioning the first segment 102 to a second position in which the longitudinal axis of the first segment 102 has a non-zero angle with respect to the longitudinal axis of the second segment 108.

[52] In one example, the method 200 further includes (a) loading the device onto the delivery mechanism 130 of any one of the embodiments described above prior to inserting the first segment 102 of the device 100 into the incision, (b) transitioning the first segment

102 from the first position to the second position, and (c) removing the delivery mechanism

130 from the incision after transitioning the first segment 102 to the second position. In one such example, transitioning the first segment 102 from the first position to the second position comprises rotating the delivery mechanism 130. In another such example, transitioning the first segment 102 from the first position to the second position comprises retracting a sheath 146 of the delivery mechanism 130. In yet another such example. transitioning the first segment 102 from the first position to the second position comprises cutting a suture 138 of the delivery mechanism.

[53] In another example, the method 200 further includes positioning an instrument into the slot 114 recessed in the first side 110 of the second segment 108 and through the incision. In another example, the method 200 further includes removing the first segment

102 of the device 100 from the incision. In one such example, removing the first segment 102 of the device 100 from the incision comprises pulling on the second segment 108 or third segment 116 of the device 100 such that the first segment 102 temporarily straightens to thereby enable the first segment of the device 100 to be removed from the target anatomy through the incision. The material property of the device enables this temporary straightening during removal of the device 100 from the target anatomy.

[54] In the method 200 described above, the transition of the first segment 102 of the device from the first position to the second position secures the device 100 in the correct position in the target anatomy, and the position can be confirmed via an arthroscopic camera.

At the conclusion of the procedure, the device 100 can be gently pulled out of the joint and the increase force of the pulling briefly causes the first segment 102 to straighten thereby allowing the device 100 to be removed completely from the target anatomy. The first segment 102 of the device 100 may include a physical marker to ensure that the entire device has been removed from the joint without leaving any part still within the body. The device

100 may be available in a range of lengths to facilitate accessing different joints and tissue planes. The design would allow for single use during each procedure but the device 100 could be re-deployed as needed to reach different areas.

[55] It will be appreciated that other arrangements are possible as well, including some arrangements that involve more or fewer steps than those described above, or steps in a different order than those described above.

[56] While various aspects and embodiments have been disclosed herein, other aspects and embodiments will be apparent to those skilled in the art. All embodiments within and between different aspects of the invention can be combined unless the context clearly dictates otherwise. The various aspects and embodiments disclosed herein are for purposes of illustration and are not intended to be limiting, with the true scope and spirit being indicated by the claims.

Claims

1. A device comprising: a first segment having a first length, wherein the first segment has a first side and a second side opposite the first side; and a second segment having a second length, wherein the second segment has a first side and a second side opposite the first side, wherein the first segment is directly coupled to the second segment such that the first segment extends away from the second side of the second segment, and wherein the second segment includes a slot recessed in the first side of the second segment.

2. The device of claim 1 , further comprising: a third segment having a third length, wherein the third segment has a first side and a second side opposite the first side, and wherein the third segment is directly coupled to the second segment such that the third segment extends away from the second side of the second segment.

3. The device of claim 2, wherein the first segment, the second segment, and the third segment are formed unitarily.

4. The device of any one of claims 2-3, wherein the second side of the first segment and the second side of the second segment define a first angle, and wherein the second side of the third segment and the second side of the second segment define a second angle.

5. The device of claim 4, wherein the first angle is equal to the second angle.

6. The device of claim 4, wherein the first angle is greater than the second angle.

7. The device of claim 4, wherein the first angle is less than the second angle.

8. The device of claim 4, wherein the first angle ranges from about 30 degrees to about 100 degrees, and wherein the second angle ranges from about 10 degrees to about 120 degrees.

9. The device of any one of claims 2-8, wherein the second side of the first segment and the second side of the second segment define a first radius of curvature, and wherein the second side of the third segment and the second side of the second segment define a second radius of curvature.

10. The device of claim 9, wherein the first radius of curvature is equal to the second radius of curvature.

11. The device of claim 9, wherein the first radius of curvature is greater than the second radius of curvature.

12. The device of claim 9, wherein the first radius of curvature is less than the second radius of curvature.

13. The device of any one of claims 2-12, wherein the first segment, the second segment, and the third segment each comprise the same material.

14. The device of any one of claims 2-12, wherein the first segment and the second segment each comprise a first material, and wherein the third segment comprises a second material that is different than the first material.

15. The device of any one of claims 2-14, wherein the first length, the second length, and the third length are equal.

16. The device of any one of claims 2-15, wherein the second length is greater than the first length, and wherein the third length is greater than the first length but less than the second length.

17. The device of any one of claims 2-17, wherein the first length ranges fiom about 0.5 cm to about 2.5 cm, wherein the second length ranges fiom about 0.5 cm to about

20 cm, and wherein the third length ranges from about 0.5 cm to about 4.5 cm.

18. The device of any one of claims 1-17, further comprising a channel having a first end coupled to the first side of the second segment such that the slot and the channel are aligned, wherein the channel further includes a second end extending away fiom the second segment.

19. The device of claim 18, wherein the first end of the channel has a first width that matches a width of the slot, and wherein the second end of the channel has a second width that is greater than the first width.

20. The device of any one of claims 18-19, wherein a ratio of the second width of the second end of the channel to the first width of the first end of the channel is between about 2:1 and about 5:l.

21. The device of any one of claims 18-20, wherein the channel is a semi-circular funnel shape.

22. The device of any one of claims 1-21, wherein the slot extends to the first segment such that the slot is recessed in the first side of the first segment.

23. The device of any one of claims 1-22, wherein the first segment is configured to transition from a first position in which a longitudinal axis of the first segment is substantially aligned with a longitudinal axis of the second segment to a second position in which the longitudinal axis of the first segment has a non-zero angle with respect to the longitudinal axis of the second segment.

24. The device of any one of claims 1-23, further comprising an indicator positioned between the second side of the first segment and the second side of the second segment.

25. A system comprising: the device of any one of claims 1-24; and a delivery mechanism configured to transition the first segment of the device from a first position in which a longitudinal axis of the first segment is substantially aligned with a longitudinal axis of the second segment to a second position in which the longitudinal axis of the first segment has a non-zero angle with respect to the longitudinal axis of the second segment.

26. The system of claim 25, wherein the delivery mechanism comprises a rigid member having a first end and a second end, wherein the device is temporarily coupled to the first end of the rigid member in the first position, and wherein the device is decoupled from the first end of the rigid member in the second position.

27. The system of claim 26, wherein the device is temporarily coupled to the first end of the rigid member via a suture in the first position, and wherein the device is decoupled from the first end of the rigid member by cutting the suture to thereby transition the first segment of the device from the first position to the second position.

28. The system of claim 26, wherein the first end of the rigid member includes a first hook configured to removably secure the first segment of the device to the first end of the rigid member.

29. The system of claim 28, wherein the rigid member further comprises a second hook arranged perpendicular to the first hook and positioned between the first end and the second end of the rigid member.

30. The system of any one of claims 28-29, wherein the device is decoupled from the first end of the rigid member by a rotation of the rigid member to thereby transition the first segment of the device from the first position to the second position.

31. The system of any one of claims 26-30, wherein the rigid member includes a through-hole that extends from the first end to the second end for positioning of a guidewire therethrough.

32. The system of any one of claims 26-31, wherein the first end of the rigid member comprises an atraumatic tip.

33. The system of claim 25, wherein the delivery mechanism comprises a sheath configured to at least partially surround the first segment in the first position, and wherein the sheath is retractable to transition the first segment of the device from the first position to the second position.

34. The system of any one of claims 25-33, wherein the deliver}' mechanism is disposable.

35. The system of any one of claims 25-34, wherein the delivery mechanism includes one or more measurement markings positioned thereon.

36. A method comprising: forming an incision at a target anatomy; inserting the first segment of the device of any one of claims 1-24 into the incision at the target anatomy, wherein, during insertion, the first segment is in a first position in which a longitudinal axis of the first segment is substantially aligned with a longitudinal axis of the second segment; and after the first segment is positioned into the incision, transitioning the first segment to a second position in which the longitudinal axis of the first segment has a non-zero angle with respect to the longitudinal axis of the second segment.

37. The method of claim 36, further comprising: loading the device onto the delivery mechanism of any one of claims 25-35 prior to inserting the first segment of the device into the incision; transitioning the first segment from the first position to the second position; and removing the delivery mechanism from the incision after transitioning the first segment to the second position.

38. The method of claim 37, wherein transitioning the first segment from the first position to the second position comprises rotating the delivery mechanism.

39. The method of claim 37, wherein transitioning the first segment from the first position to the second position comprises retracting a sheath of the delivery mechanism.

40. The method of claim 37, wherein transitioning the first segment from the first position to the second position comprises cutting a suture of the delivery mechanism.

41. The method of any one of claims 36-40, further comprising: positioning an instrument into the slot recessed in the first side of the second segment and through the incision.

42. The method of any one of claims 36-41, further comprising: removing the first segment of the device from the incision.

43. The method of claim 42, wherein removing the first segment of the device from the incision comprises pulling on the second segment of the device such that the first segment temporarily straightens to thereby enable the first segment of the device to be removed from the target anatomy through the incision.

44. The method of any one of claims 36-43, wherein the target anatomy comprises one of a knee, a shoulder, or a hip.