The present disclosure relates generally to surgical apparatuses for use in minimally invasive surgical procedures, such as endoscopic and/or laparoscopic procedures, and more particularly, the present disclosure relates to a surgical apparatus including a specimen retrieval device for collecting body tissue(s) and/or body fluid(s) during these procedures.
Minimally invasive surgery, such as endoscopic surgery, reduces the invasiveness of surgical procedures. Endoscopic surgery involves surgery through body walls, for example, viewing and/or operating on the ovaries, uterus, gall bladder, bowels, kidneys, appendix, etc. There are many common endoscopic surgical procedures, including arthroscopy, laparoscopy, gastroentroscopy and laryngobronchoscopy, just to name a few. In these procedures, trocars are utilized for creating incisions through which the endoscopic surgery is performed. Trocar tubes or cannula devices are extended into and left in place in the abdominal wall to provide access for endoscopic surgical tools. A camera or endoscope is inserted through a trocar tube to permit the visual inspection and magnification of a body cavity. The surgeon can then perform diagnostic and/or therapeutic procedures at the surgical site with the aid of specialized instrumentation, such as forceps, graspers, cutters, applicators, and the like, which are designed to fit through additional cannulas.
When removing certain tissues from the body cavity, for example tumor tissue, it is important that the tumor tissue does not come into contact with healthy or uninvolved tissue. If tumor tissue or tissue parts have to be removed, they may be introduced into an “extraction bag,” also referred to herein as a “specimen bag,” at the site where the tumor or diseased tissue has been detached from the surrounding tissue, after which the specimen bag is withdrawn from the body, thereby minimizing contact of the diseased tissue with healthy tissue.
Improved specimen bags for use in minimally invasive surgical procedures remain desirable.
The present disclosure is directed to surgical apparatuses and methods for their use in minimally invasive surgery. In embodiments, the present disclosure is directed to a specimen retrieval device including a tubular body defining a longitudinal bore, the tubular body having a proximal portion, a distal portion, and a hand grip supported on the proximal portion of the tubular body. The specimen retrieval device also includes an inner shaft having a proximal portion, a distal portion, an actuation handle supported on the proximal portion of the inner shaft, and a support member extending from a distal portion of the inner shaft. The specimen retrieval device further includes a specimen bag supported on the support member at the distal portion of the inner shaft, the specimen bag including an open end, a body, a closed portion, and an inner surface, the body of the specimen bag including a plurality of folds between the open end and the closed portion, the plurality of folds being movable from a folded state to an unfolded state to increase a volume of the specimen bag, and a release string secured to the plurality of folds, the release string movable from a non-actuated position to an actuated position to sequentially release at least one of the plurality of folds from the folded state to the unfolded state to increase the volume of the bag.
In embodiments, the inner surface of the specimen bag includes flanges attached thereto, each flange having a hole therein, and the plurality of folds each include flanges extending therefrom, each flange having a hole therein.
In some embodiments, the release string has a knot at a distal portion thereof.
In other embodiments, a first hole in a first flange extending from each of the plurality of folds furthest from the distal portion of the inner shaft is of a smaller diameter compared with the holes in the remaining flanges extending from the plurality of folds.
In embodiments, the plurality of folds is from two folds to ten folds.
In some embodiments, the plurality of folds includes two folds.
In other embodiments, the plurality of folds includes three folds.
In yet other embodiments, the plurality of folds includes five folds. In embodiments, the adjustable volume specimen bag permits the formation of a specimen bag of varying volumes of 250 ml, 500 ml, 1000 ml, 1200 ml and 1500 ml.
In some embodiments, the support member includes a pair of resilient fingers which support the specimen bag and open the open end of the specimen bag in the deployed state.
In other embodiments, the resilient fingers are positioned adjacent the open end of the specimen bag to open the specimen bag when the specimen retrieval device is in the deployed state.
Methods of the present disclosure include, in embodiments, introducing a tubular body of a specimen retrieval device through a body opening into a body cavity; moving an inner shaft including a support member within a longitudinal bore of the tubular body to position a specimen bag supported on the support member within the body cavity; and withdrawing a release string from the specimen bag to incrementally increase a volume of the specimen bag.
In embodiments, withdrawing the release string from the specimen bag includes proximally pulling the release string so that the release string passes through holes on flanges extending from a plurality of folds on the specimen bag and holes on flanges extending from an inner surface of the specimen bag.
In some embodiments, withdrawing the release string from the specimen bag includes proximally pulling the release string so that the release string passes through holes on flanges extending from at least one fold of the plurality of folds on the specimen bag and holes on flanges extending from an inner surface of the specimen bag.
In embodiments, the method of the present disclosure further includes passing a tissue specimen through an opening of the specimen bag into the specimen bag; and removing the specimen retrieval device from the body cavity.
In some embodiments, the method further includes closing the opening of the specimen bag before removing the specimen retrieval device from the body cavity.
In other embodiments, closing the opening of the specimen bag occurs by proximally pulling a pull string extending about the opening of the specimen bag.
Various embodiments of the presently disclosed specimen retrieval device are described herein below with reference to the drawings, wherein:
The present disclosure provides a specimen retrieval device for use in minimally invasive surgical procedures. As used herein with reference to the present disclosure, minimally invasive surgical procedures encompass laparoscopic procedures, arthroscopic procedures, and endoscopic procedures, and refer to procedures utilizing scopes or similar devices having relatively narrow operating portions capable of insertion through a small incision in the skin.
The aspects of the present disclosure may be modified for use with various methods for retrieving tissue specimens during minimally invasive surgical procedures, sometimes referred to herein as minimally invasive procedures. Examples of minimally invasive procedures include, for example, cholecystectomies, appendectomies, nephrectomies, colectomies, splenectomies, and the like.
The presently disclosed specimen retrieval device will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. In this description, the term “proximal” is used generally to refer to that portion of the device that is closer to a clinician, while the term “distal” is used generally to refer to that portion of the device that is farther from the clinician. The term “clinician” is used generally to refer to medical personnel including doctors, surgeons, nurses, and support personnel.
Referring to
The hand grip 15 on the tubular body 12 may be formed as a unitary component or, as depicted in
The actuation handle 25 on the inner shaft 22 may likewise be formed as a unitary component or, in embodiments, as depicted in
The tubular body 12 and/or the inner shaft assembly 22 of the present disclosure are made of biocompatible materials within the purview of those skilled in the art, in embodiments, polymeric materials. For example, the tubular body 12 and/or the inner shaft assembly 22 may be made of polycarbonates or thermoplastic polyurethanes sold under the name PELLETHANE®, which offer flexibility and a wide range of hardness. The tubular body 12 and/or the inner shaft assembly 22, for example, may be fabricated from PELLETHANE® 2363-80A, PELLETHANE® 2363-90A, PELLETHANE® 2363-55D, any combination thereof, or any alternatives within the purview of those skilled in the art.
In some embodiments, the tubular body 12 and the inner shaft assembly 22 are formed of the same material. In other embodiments, the tubular body 12 and the inner shaft assembly 22 are formed of different materials.
The adjustable volume specimen bag 40 includes a body 44 having a generally tubular or elongated configuration that is defined by an openable and closable portion (or mouth) 42 and a closed portion 46 (
The body 44 of the adjustable volume specimen bag 40 may be made from any suitable biocompatible material (e.g., nylon, urethane, ripstop nylon or latex) capable of forming a flexible collapsible member, or membrane. In embodiments, the material from which the adjustable volume specimen bag 40 is made is resilient, antistatic, pyrogen-free, non-toxic, and sterilizable. The adjustable volume specimen bag 40 may be opaque or clear. In some embodiments, the body 44 of the adjustable volume specimen bag 40 is formed of a nylon material, or combinations of nylon materials.
Referring to
The resilient fingers 30, 32 return to the non-deformed state (
In an assembled configuration, the hand grip 15 and the actuation handle 25 can be manipulated to facilitate manipulation of the specimen retrieval device 10 and the sliding of the inner shaft 22 within the tubular body 12. More specifically, the hand grip 15 can be grasped by the clinician with one hand and the actuation handle 25 can be grasped by the clinician with the other hand to move the inner shaft 22 within the tubular body 12.
In embodiments, the mouth 42 of the adjustable volume specimen bag 40 has a pull string 90 attached thereto (
In use, the tubular body 12 of the specimen retrieval device 10 can be inserted through an incision (not shown) with the adjustable volume specimen bag 40 furled about the inner shaft 22 and positioned within the tubular body 12 to position the adjustable volume specimen bag 40 in a body cavity adjacent a surgical site. When the tubular body 12 is properly positioned, the clinician can grip the hand grip 15.
The clinician then pushes the actuation handle 25 (
Turning to
The inner surface 52 of the adjustable volume specimen bag 40 has flanges 60 thereon, each flange 60 having a hole 62 therein. Flanges 54 also extend from the folds 50a, 50b, and 50c of the adjustable volume specimen bag 40. Each flange 54 has a hole 56 therein.
As shown in
As shown in
As shown in greater detail in
As shown in
In use, the proximal portion of the specimen retrieval device 10 is introduced into a patient so that the folded adjustable volume specimen bag 40 is deployed within the patient, The clinician proximally pulls the pull ring 90 (
As shown in
If the size of a tissue specimen to be removed from a patient can fit into the adjustable volume specimen bag 40 of the first size “S1”, then the clinician will stop proximally pulling the release string 70, and the specimen retrieval device 10, having the tissue specimen within the adjustable volume specimen bag 40, may be removed from the patient.
If, however, the size of a tissue specimen to be removed from a patient cannot fit into the adjustable volume specimen bag 40 of the first size “S1”, then the clinician will exert greater tension to pull the release string 70 so that the knot 80 at the distal portion 72 of the release string 70 passes through the first hole 56a in the first flange 54a on the second fold 50b and continue proximally pulling the release string 70 so that the knot 80 at the distal portion 70 of the release string 70 passes through the remaining holes 56b in the flanges 54b extending from the second fold 50b, as well as the holes 62 in the flanges 60 on the inner surface 52 of the adjustable volume specimen bag 40 adjacent the second fold 50b, until the knot 80 reaches the first hole 56a in the first flange 54a on the third fold 50c. Once the release string 70 passes through the remaining holes 56b associated with the second fold 50b, the second fold 50b is no longer held in place by the release string 70 and unfolds to form the adjustable volume specimen bag 40 of a second size “S2”. (
The first hole 56a extending from the first flange 54a on the third fold 50c will stop the knot 80 at the distal portion 72 of the release string 70 from passing therethrough, at which point the clinician will decide whether or not to continue to proximally pull the release string 70 to increase the volume of the adjustable volume specimen bag 40. In this case, the knot 80 topping the movement of the release string 70 at the first hole 56a in the first flange 54a on the third fold 50c provides the clinician with feedback of the expansion of the adjustable volume specimen bag 40.
If the size of a tissue specimen to be removed from a patient can fit into the adjustable volume specimen bag 40 of the second size “S2”, then the clinician will stop proximally pulling the release string 70, and the specimen retrieval device 10, having the tissue specimen within the adjustable volume specimen bag 40, may be removed from the patient.
If, however, the size of a tissue specimen to be removed from a patient cannot fit into the adjustable volume specimen bag 40 of the second size “S2”, then the clinician will exert greater tension to pull the release string 70 so that the knot 80 at the distal portion 72 of the release string 70 passes through so that the knot 80 at the distal portion 72 of the release string 70 passes through the first hole 56a in the first flange 54a on the third fold 50c and continue proximally pulling the release string 70 so that the knot 80 at the distal portion of the release string 70 passes through the remaining holes 56b in the flanges 54b extending from the third fold 50c, as well as the holes 62 in the flanges 60 on the inner surface 52 of the adjustable volume specimen bag 40 adjacent the third fold 50c. Once the release string 70 passes through the remaining holes 56b associated with the third fold 50c, the third fold 50c is no longer held in place by the release string 70 and unfolds to form the adjustable volume specimen bag 40 of a third size “S3”. (
As depicted in
As noted above, while the adjustable volume specimen bag 40 depicted in
Kits of the present disclosure may include both the specimen retrieval device described above, as well as trocars, graspers, vacuum sources (tubes), combinations thereof, and the like. In some embodiments, these additional devices, such as graspers and/or vacuum sources, may be used to break up the tissue specimen in the specimen bag prior to removing the specimen retrieval device from the body cavity.
Once the specimen retrieval device of the present disclosure has been removed from the patient's body, any tissue specimen may be removed from the adjustable volume specimen bag 40 for further examination and the adjustable volume specimen bag 40 may be discarded.
The specimen retrieval devices of the present disclosure permit the use of a single device with the adjustable volume specimen bag in a variety of procedures. During laparoscopic surgery, current specimen retrieval devices come with multiple bags of different sizes, which require the clinician to guess as to which one will be of sufficient size to remove the tissue specimen of interest. If the clinician guesses wrong, and the first bag introduced into a patient is too small, the specimen retrieval device has to be removed, and a new, larger specimen bag has to then be introduced into the patient. Thus, in accordance with the present disclosure, the removal of bags and inserting new bags is not required, thereby avoiding surgical delays. Moreover, unused bags are not wasted.
While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto. Additionally, it is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another without departing from the scope of the present disclosure, and that such modifications and variations are also intended to be included within the scope of the present disclosure. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.
This application claims the benefit of and priority to U.S. Provisional Patent Application No. 62/733,095 filed Sep. 19, 2018, the entire disclosure of which is incorporated by reference herein.
Number | Date | Country | |
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62733095 | Sep 2018 | US |