The history of artificial disc placements in the entire human spine, and in particular the lumbar spine has been thoroughly reviewed in our previous co-pending patent application Ser. No. 10/964,633, filed on Oct. 15, 2004, co-pending patent application Ser. No. 11/487,415, filed Jul. 17, 2006, and in our issued U.S. Pat. No. 7,083,650. In our '650 patent, we described the surgical posterior unilateral placement of an artificial lumbar disc. Prior to its surgical placement into a disc space, a complete unilateral discectomy (removal of disc material) must be performed to denude the opposing vertebral body endplates to ensure that the spikes of the artificial disc plates can penetrate the vertebral bodies, and that the disc material is freed from the disc space to allow unencumbered disc motion, and prevention of recurrent disc herniations.
During surgical placement of anterior artificial lumbar discs, visualization of the disc space is not a technical problem because the entire diameter and depth of the disc space can be exposed anteriorly with adequate visualization needed to accomplish surgical disc denudement. This is not as easily accomplished through the unilateral posterior discectomy, where visualization is limited to the side of unilateral implantation, and the middle and contralateral disc can not be visualized completely without causing undue retraction of the lumbar nerve root, and even then, full visualization is not adequately achieved.
To remedy this problem, we disclosed in the '650 patent a wired action-ended pituitary rongeur endoscope with centralized illumination emanating between upper and lower pituitary forceps. The advantage of that design was that it could more easily be placed in the small disc space and provide centralized illumination, neither of which is available in another wired action-ended endoscope design described in U.S. Pat. No. 5,667,472 (Finn et al.), “Surgical instrument and method for use with a viewing system”, issued Sep. 16, 1997. In that design the illumination is provided by a tube lateral to the instrument inside the disc space which might endanger the nerve root by over-retraction, and would provide poorer illumination by not focusing on the center of field of vision.
In the present patent application we describe an enhanced design of action-ended endoscopes without encumbrance of wired attachments, and also including a self-contained mounted viewing screen. In totality this design enhances surgical efficiency with respect to operating room time, ergonomics, and financial investment.
To our knowledge, this is the first action-ended endoscope which can function with the complete absence of wires by utilizing a novel induction coil converter converting low voltage power to transient high-powered sparks to initiate gas breakdown of xenon and other molecules, outputting high illumination thereby achieving luminescence equal to wired xenon systems. Another entirely novel aspect of this endoscope is an embodiment which can differentially direct light output in multiple radial and linear directions with digitally controlled reflectors. It can also be easily adapted with lasers to use as a routine laser surgical tool in addition to illumination, forceps grapping, and video display. Furthermore images can be wirelessly transmitted to a mounted self-contained system viewing screen. In addition, it has the capacity to wirelessly transmit images to routine stationary screens, customized work stations, as well as to palm pilots and mobile phones. A further novel application is the ability to manually or electronically control the end manipulator forceps so that it can work as a straight, up or down biter pituitary rongeur combining three types of instruments into one. These modifications with all the above mentioned functions contained within a single action ended-device are entirely unique to endoscopic design to date.
The present invention minimizes operating room clutter associated with routine endoscopic/laser equipment, has a self contained imaging screen, as well as optional therapeutic laser capacities. These functions allow operations to be performed in any sized operating room or military field, thus significantly reducing capital investment, and enhancing surgical and ergonomic efficiency. It also allows surgeries to be performed in places where there might not be any available electrical outlets or electricity or other power sources.
Additional inventions presented here are uniquely related to the design of our lumbar artificial disc design described in co-pending patent application Ser. No. 11/487,415, filed Jul. 17, 2006. These inventions include an instrument which allows easy placement and removal of our lumbar disc ball between upper and lower disc plates, and a disc plate extractor which can extract the device if necessary. There are further modifications of the disc plates including rescue plates with longer spikes, and/or increased plate diameters, akin to rescue screws used for spinal fusion. If a plate falls out under harsh conditions because the spikes are too short, the plate can be rescued with longer/wider spikes or increased width and or ball diameter.
The history of endoscopy, and neuroendoscopy in particular is thoroughly reviewed in “Intracranial endoscopic Neurosurgery”, Editor, David F. Jimenez, The American Association of Neurological Surgeons, 1998.
Recent devices to further enhance endoscopic functions include a device which rotates images using an image sensor to act like a gyroscope or a pair of accelerometers, U.S. Pat. No. 7,037,258, B2, (Chatenever et al.) “Image orientation for endoscopic video displays”, issued May 2, 2006. A remote surgical support system has been described wherein the state of the surgical instrument and the patient data can be checked in remote control rooms, U.S. Pat. No. 6,955,671 B2, (Uchikubo), “Remote Surgery support system”, issued Oct. 18, 2005. Neither of these devices are wireless, or are incorporated into distal action instruments. Neither, do they incorporate any of the advanced technology and wireless transmission of images, or enable differential directional illumination as does our invention.
Another wireless video system entails an in-vivo camera system which is swallowed by the patient, captures and then transmits images of the gastrointestinal tract thereby functioning as an autonomous video endoscope. (See U.S. Pat. No. 6,904,308 B2 (Frisch et al.), “Array system and method for locating an in vivo signal source”, issued Jun. 7, 2005). The patient must wear an antenna array with two antennas. The signals received by the two antennas derive an estimated coordinate set from the signal strength measurements. This innovative device functions specifically as an imaging/camera device. The patient must wear an electrode array to capture the signals over his/her abdomen. It is not designed, nor intended to be a combined surgical tool which performs surgical tool functions e.g. tissue grabbing, suction, cutting etc, which significantly distinguishes it from our invention.
Two more recent patents incorporating wireless technology include U.S. Pat. No. 7,097,615, (Banik et al.), “Robotic endoscope with wireless interface Aug. 29 2006), and U.S. Pat. No. 7,030,904 B2, (Adair et al.), “Reduced area imaging device incorporated within wireless endoscopic devices” Apr. 18 2006. Neither of these patents incorporates action-ended instruments or have a self-contained screen imaging system. Furthermore they are purely used for illumination/video, and they do not exploit our innovative technology of an induction coil thermoelectric converter to enhance wireless xenon light. They do not use controlled directional deflectors to modulate light intensity and direction. They do not have laser surgical tool capacities. They are not capable of wireless transmission to palm pilots, or cell phones.
The inventions described herein have great import not only to anterior and posterior spinal endoscopy, but can be modified and used for diagnostic and therapeutic uses in every endoscopic related field including brain, otolaryngological, pulmonary, gastrointestinal, and urological endoscopy, as well as arthroscopic joint surgery including shoulders, hips, knees, ankles, to name but a few. The multifunctional capacities compressed into a single wireless instrument enabling tissue illumination, tissue manipulation, and therapeutic laser directed treatment with a wireless, self-contained mounted viewing screen would also have profound advantages in the fields of military, emergency, ambulatory, and aerospace medicine in areas and situations where sources of electricity are not guaranteed.
In order to initiate or terminate wireless transmission of secure video and or data, the second button 202 which is immediately adjacent to the power on/off button 201, with a closed padlock icon is depressed. This information can be transmitted to the mounted system viewing screen 110, to remote unconnected devices such as a mobile phone, palm pilot, personal digital assistant (PDA), or hospital monitors and PCs. This transmission can either be broadcast, and password accessed, in any of the above receivers, or it can be communicated ad-hoc node to node with a remote device.
To transmit non-secure data i.e. open data, the third button 203 with an open padlock icon is depressed. To initiate or terminate saving of video or data into re-removable/re-readable memory drives e.g. micro secure digital the fourth button 204 with a floppy disc icon is depressed. The buttons 201-204 are housed in electronics panel 104. Slots 205 are for removable, rereadable memory drive 114, such as micro-secure digital.
Distal to the four control buttons 201-204 are three slots 205 for inserting and removing micro-secure memory cartridges 114. Slots 205A, B and C are identical slots with the capacity for data storage of contemporary maximum micro-sd capacity. Having three slots 205 multiplies this capacity threefold.
Alternative embodiments may include a solid state light source i.e. a diode light source as well as a laser source e.g. VCSEL (vertical cavity surface emitting laser), or a quantum cascade laser, a terahertz source, or a yttrium energy source. These embodiments can be used for therapeutic surgical laser treatment of tissues, (not merely illumination) as well as for tissue scanning.
To constantly energize the power battery source
The Risley prisms or semi-coated mirrors 502 can be used as shown at the terminals of the interior fibers 403a to direct a coherent beam of laser light or radiation. Also illustrated are prism or mirror axial inserts 503 that can be electronically rotated to obtain the desired beam direction.
In
The inventions described herein further enhance the capacity to implant and explant posteriorly placed artificial discs. The unique totally wireless electronically embedded action ended endoscope herein described has the capacity to revolutionize and simplify the current practice of endoscopy in lumbar spinal surgery as well as all spheres of surgical and medical subspecialties utilizing endoscopy. It is also uniquely adapted for the military surgical field, and emergency, ambulatory and aerospace medical technology.
This application is a continuation of U.S. application Ser. No. 13/596,038, filed on Aug. 27, 2012, now U.S. Pat. No. 9,801,728, which is a continuation of U.S. application Ser. No. 11/684,787, filed Mar. 12, 2007, now U.S. Pat. No. 8,251,891, which is a continuation-In-Part of application Ser. No. 10/964,633, filed on Oct. 15, 2004, now abandoned, which claims the benefit under Title 35, U.S.C. § 119 (e) of U.S. provisional application 60/578,319 filed on Jun. 10, 2004; 60/573,346 filed on May 24, 2004; 60/572,468 filed on May 20, 2004; 60/570,837 filed on May 14, 2004; and 60/570,098 filed on May 12, 2004, the entire contents of which are hereby incorporated by reference and for which priority is claimed under 35 U.S.C. § 120.
Number | Name | Date | Kind |
---|---|---|---|
4134044 | Holmes | Jan 1979 | A |
4234822 | Garrison | Nov 1980 | A |
4402311 | Hattori | Sep 1983 | A |
4471766 | Terayama | Sep 1984 | A |
4554914 | Kapp et al. | Nov 1985 | A |
4636217 | Ogilvie et al. | Jan 1987 | A |
4960420 | Goble et al. | Oct 1990 | A |
4997432 | Keller | Mar 1991 | A |
5123926 | Pisharodi | Jun 1992 | A |
5209747 | Knoepfler | May 1993 | A |
5275615 | Rose | Jan 1994 | A |
5468238 | Mersch | Nov 1995 | A |
5514180 | Heggeness et al. | May 1996 | A |
5599350 | Schulze | Feb 1997 | A |
5620458 | Green et al. | Apr 1997 | A |
5647840 | D'Amelio et al. | Jul 1997 | A |
5660188 | Groiso | Aug 1997 | A |
5667472 | Finn et al. | Sep 1997 | A |
5746770 | Zeitels | May 1998 | A |
5782832 | Larsen et al. | Jul 1998 | A |
5792165 | Klieman | Aug 1998 | A |
5827323 | Klieman | Oct 1998 | A |
5873814 | Adair | Feb 1999 | A |
5928137 | Green | Jul 1999 | A |
5960522 | Boe | Oct 1999 | A |
6086528 | Adair | Jul 2000 | A |
6126689 | Brett | Oct 2000 | A |
6221007 | Green | Apr 2001 | B1 |
6315712 | Rovegno | Nov 2001 | B1 |
6368350 | Erickson et al. | Apr 2002 | B1 |
6375682 | Fleishmann et al. | Apr 2002 | B1 |
6416463 | Tsuzuki | Jul 2002 | B1 |
6419626 | Yoon | Jul 2002 | B1 |
6419704 | Ferree | Jul 2002 | B1 |
6458159 | Thalgott | Oct 2002 | B1 |
6464633 | Hosoda | Oct 2002 | B1 |
6527804 | Gauchet et al. | Mar 2003 | B1 |
6533818 | Weber et al. | Mar 2003 | B1 |
6572653 | Simonson | Jun 2003 | B1 |
6579318 | Varga et al. | Jun 2003 | B2 |
6582468 | Gauchet | Jun 2003 | B1 |
6610093 | Pisharodi | Aug 2003 | B1 |
6641614 | Wagner et al. | Nov 2003 | B1 |
6676660 | Wampler | Jan 2004 | B2 |
6719794 | Gerber | Apr 2004 | B2 |
6723126 | Berry | Apr 2004 | B1 |
6730088 | Yeh | May 2004 | B2 |
6733532 | Gauchet et al. | May 2004 | B1 |
6764491 | Frey et al. | Jul 2004 | B2 |
6770094 | Fehling et al. | Aug 2004 | B2 |
6904308 | Frisch et al. | Jun 2005 | B2 |
6955671 | Uchikubo | Oct 2005 | B2 |
7030904 | Adair et al. | Apr 2006 | B2 |
7037258 | Chatenever et al. | May 2006 | B2 |
7097615 | Banik et al. | Aug 2006 | B2 |
7115144 | Diaz et al. | Oct 2006 | B2 |
7118580 | Beyersdorff et al. | Oct 2006 | B1 |
7214183 | Miyake | May 2007 | B2 |
7250060 | Trieu | Jul 2007 | B2 |
7252633 | Obata | Aug 2007 | B2 |
7713192 | Murata | May 2010 | B2 |
7988215 | Seibold | Aug 2011 | B2 |
20040088054 | Berry | May 2004 | A1 |
20040177531 | DiBenedetto et al. | Sep 2004 | A1 |
20040204628 | Rovegno | Oct 2004 | A1 |
20040254644 | Taylor | Dec 2004 | A1 |
20050027362 | Williams et al. | Feb 2005 | A1 |
20050049590 | Alleyne et al. | Mar 2005 | A1 |
20050085910 | Sweeney | Apr 2005 | A1 |
20050216084 | Fleischmann | Sep 2005 | A1 |
20050273170 | Navarro et al. | Dec 2005 | A1 |
20050273174 | Gordon et al. | Dec 2005 | A1 |
20050278026 | Gordon et al. | Dec 2005 | A1 |
20060004258 | Sun | Jan 2006 | A1 |
20060020167 | Sitzmann | Jan 2006 | A1 |
20060155168 | Pease | Jul 2006 | A1 |
20060167340 | Pease | Jul 2006 | A1 |
20060178745 | Bartish et al. | Aug 2006 | A1 |
20060215013 | Jongsma | Sep 2006 | A1 |
20060232669 | Abadie et al. | Oct 2006 | A1 |
20070112247 | Hirata | May 2007 | A1 |
20070129604 | Hatcher | Jun 2007 | A1 |
20070185379 | Newman | Aug 2007 | A1 |
20070249904 | Amano | Oct 2007 | A1 |
20080026269 | Shurtleff | Jan 2008 | A1 |
Entry |
---|
Traynelis, Vincent C., M. D. I Prosthetics and Biologics: The Wave of the Future,,, Clinical Neurosurgery, vol. 50, Proceedings of the Congress of Neurological Surgeons, Philidelphia, PA, 2002, Chapter 9, pp. 207-219. |
Wai, E.K. et al., Disk Replacement Arthroplasties: Can the Success of Hip and Knee Replacements be Repeated in the Spine?, Seminars in Spine Surgery, vol. 15, No. 4 (Dec.) 2003: pp. 473-482. |
Richard D. Guyer et al., “Intervertebral Disc Prostheses,” Spine Journal, vol. 28, No. 15S, Supp. To Aug. 1, 2003, pp. S15-S23. |
Dieter Grob et al., “Clinical Experience With the Dynesys Semirigid Fixation System for the Lumbar Spine,” Spine, vol. 30, No. 3, 2005, pp. 324-331. |
International Search Report {ISR) and Written Opinion of the International Searching Authority, Dec. 3, 2007, International Application No. PCT/US 07/05005. |
Number | Date | Country | |
---|---|---|---|
20180049883 A1 | Feb 2018 | US |
Number | Date | Country | |
---|---|---|---|
60578319 | Jun 2004 | US | |
60573346 | May 2004 | US | |
60572468 | May 2004 | US | |
60570837 | May 2004 | US | |
60570098 | May 2004 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 13596038 | Aug 2012 | US |
Child | 15724015 | US | |
Parent | 11684787 | Mar 2007 | US |
Child | 13596038 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 10964633 | Oct 2004 | US |
Child | 11684787 | US |