Raised Skin Excision Technique

[TheMysteryMan]

Disclaimer
I am a student of electrical engineering, not medicine. I have come here to bounce my idea off of those who are educated in dermatology. Please excuse my medical ignorance.

Introduction
I have an idea for a minimally invasive method for removing raised skin-colored benign moles/abnormalities that I'd like to bounce off of some of you dermatologists/students.

Background
I was looking around online for surgical techniques for dealing with raised skin-colored moles and I found that there were no methods that resulted in minimal scarring. In addition, there were no surgical instruments that could accommodate the procedure that I had in mind.

Thesis Statement
I believe it may be possible to achieve minimal scarring in the removal of benign raised skin-colored abnormalities by boring into the epidermis/dermis with a coaxial suction-saw.

Topic 1: The Tool
I believe I can develop and manufacture a tool that could internally excise and remove benign tissue. The tool would resemble a needle with a nominal outside diameter of no more than 0.9 mm (20 gauge needle) with a wall thickness of no more than 0.3 mm. The internal 0.6 mm space would contain coaxial angled razors that would rotate through radial grooves in the needle wall towards the tip of the needle. The outside diameter of the internal rotating shaft connected to the razors would be 0.4 mm. The remaining 0.2 mm tolerance would be used as the vacuum. The rear of the needle tool could be connected to a vacuum and this would serve to evacuate excised tissue.

Topic 2: Procedure Aftermath
After a sufficient amount of benign tissue has been excised from the epidermis/dermis, a compression bandage would be applied to the area. This would render the previously raised area flush with the surrounding skin. I believe the development of granulation tissue and epithelial cells would continue as normal considering the depth of the procedure. The resulting scar would be circular with a diameter of 0.9 mm. This is a vast improvement over ordinary excision techniques which would result in a linear scar with a length that sometimes exceeds 6 mm (depending on the size of the skin abnormality).

Conclusion
Do you suppose this is a reasonable procedure? What complications might arise from taking such an approach to excising benign tissue as opposed to conventional methods?

Note
The image included shows an example of a benign raised skin-colored abnormality that would be a candidate for this procedure.

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[asmallchild]

Disclaimer
I am a student of electrical engineering, not medicine. I have come here to bounce my idea off of those who are educated in dermatology. Please excuse my medical ignorance.

Introduction
I have an idea for a minimally invasive method for removing raised skin-colored benign moles/abnormalities that I'd like to bounce off of some of you dermatologists/students.

Background
I was looking around online for surgical techniques for dealing with raised skin-colored moles and I found that there were no methods that resulted in minimal scarring. In addition, there were no surgical instruments that could accommodate the procedure that I had in mind.

Thesis Statement
I believe it may be possible to achieve minimal scarring in the removal of benign raised skin-colored abnormalities by boring into the epidermis/dermis with a coaxial suction-saw.

Topic 1: The Tool
I believe I can develop and manufacture a tool that could internally excise and remove benign tissue. The tool would resemble a needle with a nominal outside diameter of no more than 0.9 mm (20 gauge needle) with a wall thickness of no more than 0.3 mm. The internal 0.6 mm space would contain coaxial angled razors that would rotate through radial grooves in the needle wall towards the tip of the needle. The outside diameter of the internal rotating shaft connected to the razors would be 0.4 mm. The remaining 0.2 mm tolerance would be used as the vacuum. The rear of the needle tool could be connected to a vacuum and this would serve to evacuate excised tissue.

Topic 2: Procedure Aftermath
After a sufficient amount of benign tissue has been excised from the epidermis/dermis, a compression bandage would be applied to the area. This would render the previously raised area flush with the surrounding skin. I believe the development of granulation tissue and epithelial cells would continue as normal considering the depth of the procedure. The resulting scar would be circular with a diameter of 0.9 mm. This is a vast improvement over ordinary excision techniques which would result in a linear scar with a length that sometimes exceeds 6 mm (depending on the size of the skin abnormality).

Conclusion
Do you suppose this is a reasonable procedure? What complications might arise from taking such an approach to excising benign tissue as opposed to conventional methods?

Note
The image included shows an example of a benign raised skin-colored abnormality that would be a candidate for this procedure.

I'm not sure I understand what you are asking

In the image you've uploaded, let's assume the nevus is at least 4mm in size. How would a needle that is 0.9mm in size be able to adequately excise a 4mm lesion? In this example, a nevus is solid enough that you cannot suction away the surrounding tissue after insertion of a needle, even if the needle has a saw-like apparatus at its tip

 

[Skindoc83]

I’m clearly not smart enough to understand what you’re proposing but all lesions should be removed in a way that preserves the tissue architecture for pathology. I don’t think multiple angulated blades and a vacuum will be kind to the tissue. But what do I know, crazier ideas have taken off, like the snuggie

 

[doctalaughs]

I’m also unsure what your description means (maybe a diagram or several diagrams would help).

That being said, almost no dermatologist is going to do an elliptical excision down to adipose for a benign-looking 4mm raised skin lesion. They are going to shave/saucerize it... resulting in a 4mm white flat scar.

 

[LoGo]

Disclaimer
I am a student of electrical engineering, not medicine. I have come here to bounce my idea off of those who are educated in dermatology. Please excuse my medical ignorance.

Introduction
I have an idea for a minimally invasive method for removing raised skin-colored benign moles/abnormalities that I'd like to bounce off of some of you dermatologists/students.

Background
I was looking around online for surgical techniques for dealing with raised skin-colored moles and I found that there were no methods that resulted in minimal scarring. In addition, there were no surgical instruments that could accommodate the procedure that I had in mind.

Thesis Statement
I believe it may be possible to achieve minimal scarring in the removal of benign raised skin-colored abnormalities by boring into the epidermis/dermis with a coaxial suction-saw.

Topic 1: The Tool
I believe I can develop and manufacture a tool that could internally excise and remove benign tissue. The tool would resemble a needle with a nominal outside diameter of no more than 0.9 mm (20 gauge needle) with a wall thickness of no more than 0.3 mm. The internal 0.6 mm space would contain coaxial angled razors that would rotate through radial grooves in the needle wall towards the tip of the needle. The outside diameter of the internal rotating shaft connected to the razors would be 0.4 mm. The remaining 0.2 mm tolerance would be used as the vacuum. The rear of the needle tool could be connected to a vacuum and this would serve to evacuate excised tissue.

Topic 2: Procedure Aftermath
After a sufficient amount of benign tissue has been excised from the epidermis/dermis, a compression bandage would be applied to the area. This would render the previously raised area flush with the surrounding skin. I believe the development of granulation tissue and epithelial cells would continue as normal considering the depth of the procedure. The resulting scar would be circular with a diameter of 0.9 mm. This is a vast improvement over ordinary excision techniques which would result in a linear scar with a length that sometimes exceeds 6 mm (depending on the size of the skin abnormality).

Conclusion
Do you suppose this is a reasonable procedure? What complications might arise from taking such an approach to excising benign tissue as opposed to conventional methods?

Note
The image included shows an example of a benign raised skin-colored abnormality that would be a candidate for this procedure.

PhD in biomedical engineering here. Also MD.

For small benign lesions, there are indeed techniques that have minimal scarring - a shave would be one example where the scar is no larger than the lesion itself and usually is not going very deep into the skin anyway. Cryotherapy is another example that can have excellent healing depending on the situation. Even a small ellipse excision, although longer than the lesion size and usually not needed for a small benign lesion, it can cosmetically be excellent with near zero noticeable scarring if performed correctly along natural skin tension lines or in skin folds (like nasolabial fold for example).

The method you have proposed is interesting - to me what you are describing sounds a bit like an arthroscopic shaver used in orthopedic surgery, where the instrument has a rotary saw that cuts off tissue and sucks it up the pipe. I don't think this would be very useful for skin for a few reasons.

1) skin is a much softer material than cartilage or bone, making damage to adjacent skin from suction and shearing more likely
2) if you are cutting into dermis, you will likely scar anyway. So if you have a 4mm lesion as mentioned above, you cannot have a scar smaller than that
3) if you have a more dermal/subcutaneous structure that has normal epidermis over top, presumably you could develop a device that canulates through epidermis in a small needle then debrides the entire structure subcutaneously, but then you'd end up with a empty pocket of tissue which is not great for healing or possible infection. In addition, you'd need a way to visualize whether you excised the whole thing or not, and a way to ensure you are not excising blindly into normal skin or surrounding structures like muscle, nerve, blood vessels etc.
4) the device would be relatively expensive for a dermatologist to use, while existing techniques like cryotherapy, a shave or even ellipse excision would be pretty cheap and have good scarring anyway in most cases
5) most importantly, as mentioned above, tissue usually needs to be sent to pathology and by sectioning it into micro-fragments through the rotary saw, likely the tissue will not be useful to identify what the lesion was