The invention relates to soft tissue dissectors, and more particularly, to a soft tissue dissector with suction/irrigation capability configured for use with known suction/irrigation probes.
Minimally invasive procedures have established a strong foothold in the realm of medicine. The advent of “scopes” (ex. endoscopes, laparoscopes) has allowed physicians to gain access to body chambers/potential spaces and perform therapeutic procedures which could once only be achieved in an open surgical fashion. The advantage to most minimally invasive procedures is decreased morbidity for the patient, often leading to decreased recovery times and decreased pain.
However, minimally invasive procedures can often be technically challenging in many regards. One such challenge lies in the introduction and/or exchange of surgical tools through small ports in minimally invasive procedures—these require greater time and dexterity than that required in open surgical procedures. To overcome this obstacle, surgeons may use one instrument to perform multiple functions during minimally invasive procedures. One such common practice in laparoscopic urology is to use a suction/irrigation probe to perform blunt tissue dissection. While a suction/irrigation probe has the strength and rigidity to allow surgeons to sweep away layers of soft tissue during dissection, it does not possess a tip that is ideally suited for fine soft tissue dissection. Such dissection is typically achieved using a Kittner instrument. A suction/irrigation probe may also be used to provide temporary hemostasis, by allowing a surgeon to place pressure on a bleeding vessel with the probe. However these probes are not indicated for such use. Also, the tip of a suction/irrigation probe is not ideally suited for such a function. Furthermore, a suction/irrigation probe may be used for retraction during minimally invasive procedures. The tip of current suction/irrigation probes again does not provide for an atraumatic, frictional surface that would be ideal for retraction. Finally, current suction/irrigation probes have several design limitations that become problematic with clinical use. For example, current probes often become obstructed with blood clots during suctioning. Thus, what is needed is an improved means by which surgeons can perform atraumatic soft tissue dissection, apply temporary hemostasis, and apply retraction, while simultaneously providing suction and/or irrigation capability. However, several obstacles must be overcome to design such a device.
First, Kittners for minimally invasive procedures have traditionally utilized cotton or gauze tips that provide absorbency and allow for non-traumatic soft tissue dissection. Such Kittners easily lose their shape and strength as they become saturated with fluids, and may shed fibers within the surgical field. Thus, traditional Kittners need to be replaced frequently during minimally invasive procedures. While an absorbent tip is beneficial in open procedures, such absorbency is less important in laparoscopic procedures which are performed under pneumoperitoneum and thus typically involve less blood loss. Durability, which is of little consequence in open procedures, takes on greater importance in laparoscopic procedures. With regards to a combined suction/irrigation-Kittner instrument, durability of the dissecting tip would be critical to the function of such an instrument. Without durability, multiple such instruments would need to be used through the course of one procedure, which would be cumbersome, time consuming and most importantly cost-limiting. Thus, a unique durable dissecting tip would need to be incorporated into a suction/irrigation soft tissue dissector.
Furthermore, traditional Kittners provide minimal traction or frictional surface for soft tissue dissection. Traction is necessary during soft tissue dissection to both stabilize the dissecting instrument on the surface of soft tissue as well as to allow for the dissector to more effectively dissect the tissue. Cotton/gauze based dissecting tips or instruments with smooth surfaces lack this needed traction capability. Often, surgeons have to struggle with a Kittner that routinely slips off the tissue surface, again making soft tissue dissection cumbersome and time consuming. Thus, an ideal dissecting tip would provide sufficient traction against soft tissue without causing trauma to the tissue.
In addition, the inherent “softness” of traditional Kittners also limits the “pushability” that such a device can provide. Often, surgeons need to sweep away layers of soft tissue which requires an instrument with adequate strength and pushability. Kittners utilizing soft tips have limited strength and pushability. Pushability in this context is the ability of the dissector tip to resist deformation when pressure is applied to a structure.
Yet another obstacle in fabricating an ideal suction/irrigation soft tissue dissector relates to the design of current suction/irrigation probes. Traditionally, suction/irrigation probes provide a large open-ended tip through which fluids can be aspirated and suctioned. The suctioning force is thus concentrated at the tip of the device, and often leads to the adherence of the suctioning tip to the tissue. This is not only cumbersome for the surgeon, but can also cause potential damage to the soft tissue. An ideal suctioning tip would disperse the suction force over a larger surface area, which would obviate or hinder adherence of the suctioning device to the soft tissue.
Another problem currently encountered with open ended suction irrigation probes is that these devices allow particulate material, such as blood clots, to enter the probe, only to cause obstruction downstream of the tip. While blood clots and other particulate materials do sometimes need to be removed during minimally invasive procedures, these instances are less frequent than the need to adequately suction fluids. In addition, surgeons will often employ other devices (such as forceps) to remove such materials. Thus, a suction irrigation probe that would not be prone to clogging would be a welcome improvement in the field. Additionally it would be ideal if the surgeon could filter and discriminate material being suctioned.
Some additional design issues that need to be considered in the fabrication of an ideal suction/irrigation soft tissue dissector relate to the use of such a device in providing temporary hemostasis and retraction. During minimally invasive procedures, surgeons need a fast and convenient means of applying adequate pressure to a bleeding site without causing additional trauma to the tissue. Current suction/irrigation probes are open ended thin walled tubes and thus are too aggressive and cumbersome when used to apply hemostasis. In addition, the tips of these probes tend to be somewhat sharp and can theoretically cause soft tissue trauma. Soft tissue trauma is also possible when current suction/irrigation probes are used for retraction; lack of traction at these tips also causes the device to slip off of tissue when these probes are used for retraction. Furthermore, the ability to irrigate and aspirate around the bleeding site while simultaneously holding pressure at the site would also be a welcome improvement in the field.
A final design issue that needs to be considered in the design of an ideal suction/irrigation soft tissue dissector relates to the ability of such a device to function with known suction/irrigation probes. A variety of suction/irrigation probes are available for surgical use, each with a unique tip configuration (ie. varying inner diameters, varying through-hole configurations). Thus, a soft tissue dissection tip design that would allow for use of the tip with various known suction/irrigation probes would be a welcome improvement in the field.
What is needed, therefore, are techniques for blunt dissection, retraction, application of temporary hemostasis and suction/irrigation either with a unitary device or an adjunctive dissection tip that can be coupled to known suction/irrigation probes.
One embodiment of the present invention provides a system for the dissection of soft tissue, the system comprising: a dissection tip, the tip comprising a rigid, non-absorptive, end shell; the rigid end shell having a textured exterior surface configured to purchase soft tissue and having at least one porosity; and the dissection tip being configured to be coupled to a suction source.
Another embodiment of the present invention provides such a system wherein the rigid, blunt, non-absorptive, end shell is disposed on a tubular pin.
A further embodiment of the present invention provides such a system wherein the tip is disposed on a tubular handle.
Yet another embodiment of the present invention provides such a system wherein the tip comprises a collar receiving a distal end of the tubular handle.
A yet further embodiment of the present invention provides such a system wherein the dissection tip is integral to a suction source shaft.
Still another embodiment of the present invention provides such a system further comprising a dissection tip adaptor having a distal end disposed within the rigid, blunt, end shell, the adaptor being configured to be coupled to the suction source.
A still further embodiment of the present invention provides such a system wherein the dissection tip adaptor comprises a shaft having at least one taper, such that a proximal end of the taper has a smaller exterior diameter than a distal end of the taper and the shaft may be at least temporarily fixed within a channel of the suction source.
Even another embodiment of the present invention provides such a system further comprising an annular protrusion disposed proximal to a proximal end of the dissection tip adaptor, and at least one tension release slot transecting the annular protrusion, the annular protrusion being configured to compress upon an interior wall of the suction source.
An even further embodiment of the present invention provides such a system wherein the dissection tip adaptor further comprises a threaded portion whereby the adaptor is secured to the suction source.
Still yet another embodiment of the present invention provides such a system wherein the dissection adaptor further comprises a frictive insert whereby the adaptor is secured to the suction source.
A still yet further embodiment of the present invention provides such a system wherein the dissection adaptor comprises an adhesive whereby the adaptor is secured to the suction source.
Still even another embodiment of the present invention provides such a system wherein the end shell comprises a rigid synthetic polymer.
A still even further embodiment of the present invention provides such a system wherein the rigid synthetic polymer comprises sintered particles.
Still even yet another embodiment of the present invention provides such a system wherein the at least one porosity comprises a plurality of microporosities in the shell.
A still even yet further embodiment of the present invention provides such a system wherein the end shell comprises bonded particles.
Yet still even another embodiment of the present invention provides such a system wherein the particles are selected from the group of particles consisting of stainless steel particles, metal particles, glass particles, polypropylene particles, polyethylene particles, polytetrafluoroethylene particles, plastic particles, ceramic particles, silica, and combinations thereof.
One embodiment of the present invention provides a dissector tip mounting adaptor comprising: a dissector shell; a shell support manifold, disposed within the shell and providing suction to the shell; an insert mount, configured to be received by a suction source, wherein the insert mount is coupled to the shell support manifold and suction is directed through the adaptor to the shell support manifold.
Another embodiment of the present invention provides such a dissector tip mounting adaptor wherein the insert mount comprises a material from the group of materials consisting of metals, polymers, alloys, and combinations thereof.
A further embodiment of the present invention provides such a dissector tip mounting adaptor wherein the insert mount comprises a tapered tube having a distal end of greater outside diameter than a proximal end of the tapered tube.
Still another embodiment of the present invention provides such a dissector tip mounting adaptor further comprising an annular region of increased outside diameter proximate to the proximal end of the tube.
A still further embodiment of the present invention provides such a dissector tip mounting adaptor wherein the shell comprises a cylindrical cavity having a conic terminus, the cavity configured to receive the shell support manifold.
One embodiment of the present invention provides a system for the dissection of soft tissue, the system comprising: a dissection tip, the tip comprising a rigid, blunt, non-absorptive, end shell; the rigid blunt end shell having a textured exterior surface configured to purchase soft tissue and having at least one porosity; and the dissection tip being configured to be coupled to an irrigation source.
The features and advantages described herein are not all-inclusive and, in particular, many additional features and advantages will be apparent to one of ordinary skill in the art in view of the drawings, specification, and claims. Moreover, it should be noted that the language used in the specification has been principally selected for readability and instructional purposes, and not to limit the scope of the inventive subject matter.
As illustrated in
In one embodiment of the present invention, as illustrated in
Such a tip or shell 14, illustrated in
In one embodiment of the present invention, the coupler 19 is attached to a known suction/irrigation probe using a threading mechanism. One skilled in the art will appreciate that many possible methods of attachment may be provided, such as attachment with adhesives, malleable coatings, magnets, o-rings, indentations, grooves, peening, and frictive press fit. Also illustrated in
In one embodiment of the present invention illustrated in
In one embodiment of the present invention, the tip 14 may be manufactured from a particle matrix. The particles of such a matrix may be manufactured from biocompatible material having suitable physical properties, including stainless steel, polypropylene, silica, ceramics, and polyethylene. In one embodiment of the present invention, such particles may be sintered or otherwise bonded. Bonding may be achieved by chemical or physical processes including, but not limited to ultrasonic welding, radio frequency welding, cross linking, irradiation, solvents, and compression. In embodiments where the sintered material lacks the structural integrity to resist breakage, an adaptor 24, as illustrated in
As illustrated in
In an alternative embodiment, illustrated in
A further embodiment of the present invention, illustrated in
Such an embodiment has in its design an attachment system that enables its attachment to a variety of sizes of the suction/irrigation probe's distal end tube opening without a variety of different sized adaptors. This unique design also allows such embodiments of the present invention to remain securely attached to the suction/irrigation probe even when not fully or properly installed, reducing the likelihood that the device could get dislodged during a surgery.
In another embodiment of the present invention, illustrated in
In an alternative embodiment illustrated in
In an alternative embodiment illustrated in
An additional embodiment, illustrated in
The foregoing description of the embodiments of the invention has been presented for the purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise form disclosed. Many modifications and variations are possible in light of this disclosure. It is intended that the scope of the invention be limited not by this detailed description, but rather by the claims appended hereto.
This application claims the benefit of U.S. Provisional Application No. 61/185,348, filed Jun. 9, 2010. This application is herein incorporated by reference in its entirety for all purposes.
Number | Date | Country | |
---|---|---|---|
61185348 | Jun 2009 | US |