i. Field of the Invention
The present invention generally relates to surgical devices and, more particularly, to surgical devices for capturing and retrieving tissue from within a patient's body.
ii. Description of the Related Art
Traditional, or open, surgical techniques may require a surgeon to make large incisions in a patient's body in order to access a tissue treatment region, or surgical site. In some instances, these large incisions may prolong the recovery time of and/or increase the scarring to the patient. As a result, minimally invasive surgical techniques are becoming more preferred among surgeons and patients owing to the reduced size of the incisions required for various procedures. In some circumstances, minimally invasive surgical techniques may reduce the possibility that the patient will suffer undesirable post-surgical conditions, such as scarring and/or infections, for example. Further, such minimally invasive techniques can allow the patient to recover more rapidly as compared to traditional surgical procedures.
Endoscopy is one minimally invasive surgical technique which allows a surgeon to view and evaluate a surgical site by inserting at least one cannula, or trocar, into the patient's body through a natural opening in the body and/or through a relatively small incision. In use, an endoscope can be inserted into, or through, the trocar so that the surgeon can observe the surgical site. In various embodiments, the endoscope may include a flexible or rigid shaft, a camera and/or other suitable optical device, and a handle portion. In at least one embodiment, the optical device can be located on a first, or distal, end of the shaft and the handle portion can be located on a second, or proximal, end of the shaft. In various embodiments, the endoscope may also be configured to assist a surgeon in taking biopsies, retrieving foreign objects, and introducing surgical instruments into the surgical site.
Laparoscopic surgery is another minimally invasive surgical technique where procedures in the abdominal or pelvic cavities can be performed through small incisions in the patient's body. A key element of laparoscopic surgery is the use of a laparoscope which typically includes a telescopic lens system that can be connected to a video camera. In various embodiments, a laparoscope can further include a fiber optic system connected to a halogen or xenon light source, for example, in order to illuminate the surgical site. In various laparoscopic, and/or endoscopic, surgical procedures, a body cavity of a patient, such as the abdominal cavity, for example, can be insufflated with carbon dioxide gas, for example, in order to create a temporary working space for the surgeon. In such procedures, a cavity wall can be elevated above the organs within the cavity by the carbon dioxide gas. Carbon dioxide gas is usually used for insufflation because it can be easily absorbed and removed by the body.
In at least one minimally invasive surgical procedure, an endoscope and/or laparoscope can be inserted through a natural opening of a patient to allow a surgeon to access a surgical site. Such procedures are generally referred to as Nature Orifice Transluminal Endoscopic Surgery or (NOTES)™ and can be utilized to treat tissue while reducing the number of incisions, and external scars, to a patient's body. In various NOTES procedures, for example, an endoscope can include at least one working channel defined therein which can be used to allow the surgeon to insert a surgical instrument therethrough in order to access the surgical site.
According to at least one aspect, surgical instruments including a tissue holder and a specimen retrieval receptacle can be utilized to facilitate the capture and retrieval of a tissue specimen from a surgical site. In various embodiments, as described herein, such a surgical instrument can allow a surgeon to easily grasp and retrieve a specimen from a surgical site using a single trocar port, for example. In at least one embodiment, the surgical instrument can include a grasper, wherein the grasper can include one or more jaws which can be inserted through the trocar port. Once inserted therethrough, the jaws can be opened and closed, as needed, in order to capture tissue therebetween. A specimen retrieval bag can be slid relative to the grasper and positioned such that the specimen is at least partially surrounded by the specimen retrieval bag. In various embodiments, the surgical instrument can further include an actuator operably engaged with the specimen retrieval bag, wherein the actuator can be configured to move the specimen retrieval bag between undeployed and deployed positions. In certain embodiments, the actuator can comprise a snare loop which can be engaged with at least a portion of the perimeter of the specimen retrieval bag such that the snare loop can at least partially close the bag. Once the specimen retrieval bag has been suitably positioned and/or closed, the specimen retrieval bag can be removed from the surgical site though the trocar lumen. In at least one embodiment, the specimen retrieval bag and the grasper can be pulled through the trocar at the same time while, in other embodiments, the specimen retrieval bag and the grasper can be pulled through the trocar sequentially. In any event, in various embodiments, a specimen can be grasped, manipulated, and removed from a surgical site through a single trocar utilizing a single surgical instrument.
The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:
Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate preferred embodiments of the invention, in one form, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.
During the course of various surgical procedures, especially in intraluminal and transluminal procedures, there often exists a need to simultaneously introduce several surgical instruments into a surgical cavity, for example. Various surgical instruments include, for example, a grasper configured to gain control of a specimen and a specimen retrieval pouch configured to isolate and remove the specimen from the surgical cavity. According to various surgical procedures, a first trocar is inserted into the surgical cavity to introduce the grasper into the surgical cavity and, in addition, a second trocar is inserted into the surgical cavity to introduce the retrieval pouch into the surgical cavity.
Among the greatest difficulties in performing surgical procedures, especially in intraluminal and transluminal procedures, is limiting the number of peritoneal insults required to complete the surgical procedure. For example, intraluminal and transluminal procedures to retrieve tissue, or other specimens, from a peritoneal surgical site often incorporate the use of a grasper and a specimen retrieval bag, wherein each device is introduced through a separate trocar, and wherein each trocar can create an insult to a peritoneal cavity wall, for example. Stated another way, each additional trocar can introduce an additional peritoneal insult, thereby significantly increasing the time and complexity of the surgical procedure and, in addition, the risks for port site infection, herniation, and recovery time for the patient, for example.
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 of ordinary skill 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 various embodiments 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.
In various embodiments, a surgical instrument, and/or surgical instrument kit, can include components which can be configured to grasp and retrieve a specimen from within the body of a patient such that a surgeon can easily access, and retrieve a specimen within, a surgical site using a single surgical instrument. In at least one embodiment, referring to
In various embodiments, as outlined above, the surgical instrument 10 can include a grasper 40, and/or any other suitable grasping device, for example. The grasper 40 can be cylindrical, at least substantially cylindrical, and/or any other suitable shape and can define a grasper lumen (not shown) extending along the length thereof. According to at least one embodiment, the grasper 40 can be an approximately 5 mm diameter grasper. In certain embodiments, the grasper 40 can include one or more grasper jaws, such as grasper jaws 42 and 42′, for example. The grasper jaws 42 and 42′ can be configured to be transitioned from an expanded, or open, position, where the interior distal tips of jaws 42 and 42′ are apart from one another, to a collapsed, or closed, position, where the interior distal tips of jaws 42 and 42′ are in contact with one another, or at least adjacent to one another, in order to capture a specimen therebetween. In at least one embodiment, the grasper jaws 42 and 42′ can be configured to be slidably received within, and extendable from, the grasper lumen and, in various embodiments, grasper 40 can include suitable controls for manipulating grasper jaws 42 and 42′. In certain embodiments, a grasper can include a corkscrew, a hook, a vacuum source, a T-tag deployer and/or any other suitable device capable of capturing a specimen.
In various embodiments, as also outlined above, the surgical instrument 10 can include specimen retrieval bag 30 and/or any other suitable specimen receptacle, for example. In at least one embodiment, the distal end of the specimen retrieval bag 30 can be configured to be attached to the distal end of the grasper 40 by an attachment mechanism 36. In various embodiments, attachment mechanism 36 can comprise a closable device which can apply a compressive force to bag 30 and grasper 40, such as a zip tie, for example. In certain embodiments, retrieval bag 30 can be affixed to grasper 40 by an adhesive and/or a fastener, for example. In various embodiments, retrieval bag 30 can include a first end 31 affixed to grasper 40 and a second end 33 which can be moved relative to the first end 31. As will be described in greater detail below, the second end 33 of retrieval bag 30 can be repositioned such that retrieval bag 30 can at least partially cover or encapsulate the targeted specimen.
In various embodiments, further to the above, surgical instrument 10 can include an actuator operably engaged with retrieval bag 30, wherein the actuator can be configured to move second end 33 relative to first end 31. In at least one embodiment, the actuator can be affixed to second end 33 such that the actuator can be utilized to push second end 33 distally until second end 33 at least partially covers the targeted specimen. In certain embodiments, referring primarily to
In various embodiments, referring to
In various embodiments, further to the above and referring to
In various embodiments, referring to
In various embodiments, referring to
In certain circumstances, it may be desirable to enclose, or at least substantially enclose, specimen S before it is removed from the surgical cavity. In such circumstances, the open, second end 33 of bag 30 can be closed before bag 30 and specimen S are removed from the surgical cavity. In certain embodiments, second end 33 can be closed by snare 32, for example. More particularly, snare loop 34 can be engaged with the perimeter of bag 30, or at least a portion of the perimeter of bag 30, such that, when the diameter, and/or circumference, of snare loop 34 is decreased, the perimeter of bag 30 can be drawn together, as illustrated in
As outlined above, a portion of retrieval bag 30 can be affixed to grasper 40, for example. In various alternative embodiments, a specimen retrieval bag may not be affixed to a grasper. In at least one embodiment, although not illustrated, the entire specimen retrieval bag can be slidable relative to the grasper such that the bag can be slid between a proximal position and a distal position. In certain circumstances, the grasper can be utilized to capture and control a specimen and the retrieval bag can be slid along the grasper until it at least partially covers the specimen. Accordingly, a surgical instrument can advantageously guide the retrieval bag as it is moved along the grasper such that the bag can be delivered directly to the specimen. Stated another way, the grasper, and/or any other suitable portion of a surgical instrument, can define a path for the specimen retrieval bag. As a result, such surgical instruments can provide an accurate and repeatable means by which to deliver a specimen retrieval bag and/or other suitable cover to a surgical site. In various embodiments, the proximal end of the bag can be at least partially closed before it is slid into place. In certain embodiments, the proximal end and/or the distal end of the bag can be at least partially closed after the bag has been suitably positioned relative to the specimen. In at least one embodiment, a surgical instrument can include a first actuator for positioning and/or closing a first end of a retrieval bag and a second actuator for positioning and/or closing a second end of the retrieval bag, wherein the first and second actuators can be selectively actuated in order to collapse, cover, and/or otherwise envelop the targeted specimen. In certain embodiments, at least a portion of a specimen retrieval bag can be detachably affixed to a surgical instrument such that the bag can be slid relative to a grasper, for example, after the bag has been detached from therefrom. In at least one embodiment, the retrieval bag can include at least one perforation, for example, which can be configured to allow the bag to release from the surgical instrument.
In various embodiments, as outlined above, the surgical instrument 10, including the grasper 40 and specimen retrieval bag 30, for example, can be retracted proximally into the trocar lumen 14 of the trocar 12, for example, in order to retrieve the specimen S from the surgical cavity. In certain embodiments, referring to
In various embodiments, referring to
The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
Preferably, the invention described herein will be processed before surgery. First, a new or used instrument can be obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument can be placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument can then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.
While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains.
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