Patent Application
20080171907
The present invention relates to methods and devices for performing surgical procedures, and in particular to methods and devices for manipulating tissue and organs.
Mechanical graspers and clamps are commonly used in a variety of medical procedures. During a laparoscopic procedure, a multitude of graspers can be introduced to provide traction and counter-traction, particularly during dissection, such as required during a cholecystectomy procedure.
In certain laparoscopic surgical procedures, mechanical graspers can be introduced into a patient's body via small incisions in the abdomen. The graspers can then assist in controlling and manipulating an organ that requires removal. However, the dissection of organs can result in complications, such as damage to surrounding organs and vessels due, for example, to the lack of visibility and difficulty in handling the organs and the graspers. In addition, the introduction of a number of instruments in a restricted body cavity further hinders the visibility and manipulation of the organ.
Likewise, a surgeon can face difficulty in manipulating an instrument, such as a mechanical grasper, for controlling an organ during endoscopic procedures conducted through a natural orifice. For example, introducing a grasper endoscopically requires that the force to operate the grasper be transmitted across a typically long and convoluted pathway from an end of the grasper that is positioned outside of the patient's body to the other end of the grasper that is positioned within the body.
Accordingly, there is a need in the art for novel methods and devices for grasping and manipulating tissue or organs in a more convenient manner, with the provision of sufficient force for control.
The present invention generally provides methods and devices for grasping a target tissue and/or organs for enhanced ease of manipulation, particularly during minimally invasive surgical procedures. In one embodiment, an exemplary method for grasping tissue can include inserting a magnetic substance into an organ in a patient's body, positioning an instrument having a magnetic element adjacent to the organ to generate a magnetic field between the magnetic element and the magnetic substance, and manipulating the instrument to move the organ. The method can further include severing the organ from adjacent structures attached to the organ following manipulation of the organ. In one embodiment, the organ or tissue that is grasped and manipulated, is the gall bladder.
In one aspect, magnetic substance can be in the form of a fluid that includes a plurality of magnetic particles dispersed therein. The magnetic substance can alternatively be in the form of a structure such as a magnetic coil or a housing that contains magnetic material in liquid or solid form. In one embodiment, such as when the magnetic substance is in a fluid form, an additional magnetic element can be placed on or adjacent to a duct or vessel to prevent passage of the magnetic substance into other areas of the patient's body.
The instrument that includes a magnetic element can be inserted into the patient's body and placed adjacent to the organ, or it can be placed on an external portion of the patient's body, such as the abdomen, adjacent to the target organ.
The invention will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:
Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
The present invention generally provides methods and devices for holding and manipulating tissue, and in particular for grasping a target tissue or organ with the assistance of a magnetic field. The term “tissue” is used herein in its broad sense and includes any tissue structure within the body, including organs.
According to methods described herein, a magnetic substance can be introduced into a tissue, such as an organ tissue. By positioning an instrument having another magnetic element adjacent to the target tissue, a magnetic force is generated such that the target tissue, e.g., an organ, is effectively grasped by the instrument and it is thus capable of being manipulated. Grasping a tissue or organ magnetically is advantageous in that it enables easy and effective manipulation of tissue and/or organs, particularly when there is a need to control tissue or organs during minimally invasive surgical procedures. In addition, the use of a magnetic force to grasp tissue or an organ provides such benefits as improved traction, particularly during dissection of a tissue or an organ.
While the devices and methods disclosed herein can be used in conventional, open surgical procedures, they are particularly useful in minimally invasive surgical procedures, such as laparoscopic and endoscopic procedures. The principles described herein can be applicable to the particular types of tools described herein, and to a variety of other surgical tools having similar functions. In addition, the tools can be used alone in a surgical procedure, or they can be used in conjunction with other devices, such as endoscopes, that facilitate minimally invasive surgical procedures.
The fluid medium 22 can be virtually any biocompatible material such as a liquid or a gel. By way of non-limiting example, a fluid material can include MRF-132DG (Lord Corp., Cary, N.C.). MRF-132DG is a hydrocarbon based fluid magneto-rheological fluid, formed of a suspension of micron-sized, magnetizable particles. The fluid medium 22 can also include a wide viscosity range. In one example, the fluid can have a viscosity such that the fluid can be pass through an injection needle.
Similarly, the magnetic particles 24 can be any biocompatible magnetic materials having sufficient magnetic force to enable the tissue and/or organ within which they are disposed to be manipulated with an instrument having another magnetic material associated therewith. Exemplary materials from which the magnetic particles 24 can be formed include any steel material with a sufficient iron content to become magnetized.
In general, the magnetic particles 24 can have varying sizes and configurations. In one embodiment, the magnetic particles 24 can have a diameter such that when introduced into the organ 10, the magnetic particles 24 are unable to migrate from the tissue and/or organ, for example by passing through an artery 14 coupled to the organ 10. This avoids any passage of the magnetic particles 24 into the circulatory system. By way of example, the magnetic particles 24 can also have a configuration that enables the particles to be introduced into a tissue or organ by a variety of techniques. For example, the magnetic substance can be introduced through a device, such as a cannula, by an endoscopic or percutaneous technique.
One skilled in the art will further appreciate that the concentration of the magnetic particles can vary depending upon that specific surgical procedure that is utilized. In general, the concentration of magnetic particles 24 should be sufficient to generate a magnetic force that enables the tissue and/or organ to be manipulated with an instrument having another magnetic material associated therewith. In one embodiment the concentration of the magnetic particles can be in the range of about 50-80%.
The housing 32 can have a design and properties that enable it to be delivered to a target site through a minimally invasive technique such as a laparoscopic or an endoscopic technique. In general, the housing 32 can be rigid or flexible. In an exemplary embodiment, at least a portion of the housing 32 is sufficiently flexible to allow the housing 32 to be inserted endoscopically through a natural orifice and through a tortuous body lumen. In one embodiment, the housing 32 can be formed from an elongate tubular member. In another exemplary embodiment, the housing 32 can have a coiled configuration, as shown in
In use, the magnetic element 60 (as well as magnetic element 62 if used) serves as the counter component to the magnetic substance that will be delivered to the organ, resulting in the attractive force of the magnetic fields. The magnetic energy between a magnetic substance and a magnetic element enables a tissue or organ to be grasped magnetically with the assistance of the magnetic element once a magnetic substance has been introduced into a target organ or tissue.
One skilled in the art will appreciate that the magnetic element can be formed from any component that will create a magnetic attraction between itself and a magnetic substance. In one exemplary embodiment, the magnetic element can be an electromagnet. In another embodiment, the magnetic element can be a permanent magnet.
One skilled in the art will appreciate that it may be necessary or desirable to provide devices and methods for containing the magnetic substance within an organ or a tissue once it has been introduced. That is, the magnetic substance should be prevented from migrating out of the target organ or tissue through an opening or conduit that is either natural or surgically created. In one exemplary embodiment, a sealing mechanism (not shown) can be used to block a surgically created opening through which the magnetic substance was introduced into the tissue or organ. Such a sealing mechanism can have any configuration or size and be formed of any material which is effective to seal an opening in tissue. The sealing mechanism ensures that the magnetic particles in a magnetic substance, such as a magnetic fluid, are prevented from diffusing out of the organ or tissue through a surgically created opening.
Unwanted diffusion of the magnetic substance from a housing that contains a magnetic substance such as described with respect to
It may also be desirable to prevent the passage of the magnetic substance from the target tissue or organ through a natural opening or conduit.
Exemplary methods for magnetically grasping and manipulating a tissue or organ are further described with reference to
Following the insertion of the magnetic substance within the gall bladder 12, a magnetic element can be employed to grasp and manipulate the gall bladder 12. In one exemplary method, as illustrated in
In another embodiment, as illustrated in
Once the magnetic element is positioned through a technique as described above, a magnetic field is generated between the magnetic element and the magnetic substance, resulting in the magnetic substance being drawn toward the magnetic element. The magnetic substance thus becomes concentrated along an inner wall of the gall bladder such that it is positioned in the vicinity of the magnetic element. The magnetic attraction, as noted above, can be used to assist in manipulating the organ so that it can be severed and removed.
The magnetic attraction between the magnetic element and the magnetic substance renders the magnetic element effective to grasp and control the gall bladder as desired. The grasping force can be varied such that if the magnetic element is applied directly to a surface wall of the gall bladder, as shown in
The method described above provides many advantages. For example, the grasping of the gall bladder enables the gall bladder to lifted away from the liver, such that a cholecystectomy can be more readily and simply performed by minimally invasive surgical techniques. While the above method has been described in terms of manipulation of the gall bladder, one skilled in the art will appreciate that the methods and devices described herein are equally applicable to the manipulation of other organs or tissue in a variety of minimally invasive surgical procedures.
One skilled in the art will appreciate further features and advantages of the invention based on the above-described embodiments. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. All publications and references cited herein are expressly incorporated herein by reference in their entirety.
