The present invention relates to an endoscopic surgical hook instrument, and more particularly to a surgical hook instrument used in minimally invasive laparoscopic surgery for closing a gastric band.
One method of controlling the intake of food in an obese person is to place an adjustable restriction band 10 around the upper stomach 20, shown in
One specific type of an adjustable restriction band 10 is the LAP-BAND system manufactured by INAMED Corporation, shown in
During a minimally invasive laparoscopic surgical procedure, the tube 14 of the gastric band 10 is pushed through a laparoscopic cannula and is inserted in the patient's abdomen. The gastric band 10 is then placed around the patient's upper stomach and the tail portion 13 is inserted into the buckle 19 thereby forming a ring structure around the upper stomach. The triangular shaped member 13a of the tail portion 13 interlocks with the buckle 19 and prevents the tube 14 from slipping backwards. The process of inserting the tail portion 13 into the buckle 19 requires simultaneously grasping the buckle 19 and threading and pushing the tube 14 through the buckle conduit 19a. Minimally invasive tools are used for performing these two mechanical manipulations needed for tightening the gastric band around the upper stomach.
A prior art combination tool for grasping the pull tab 18 and pushing the tube 14 is described in U.S. Pat. No. 5,658,298. This prior art tool includes two elongated slidably mounted cylindrical members and a handpiece. At the distal end of the first cylindrical member there is a post extending downwards that is dimensioned to engage the hole 18a of the tab 18 from the top side, shown in FIG. 6 of U.S. Pat. No. 5,658,298. The second cylindrical member, which is slidably mounted with respect to the first cylindrical member, has mounted on its distal end a seat or a fork, shown in FIG. 3A of U.S. Pat. No. 5,658,298. This fork is dimensioned to capture protuberances such as the conical barb 13b at the tube end of the band 10 and push the tube 14 through the buckle conduit 19a, while the first cylindrical member engages and pulls on the pull tab 18. Surgeons performing this type of laparoscopic surgery have encountered the problems of the post unintentionally slipping out of the hole 18a and the fork unintentionally releasing the tube end of the band 10 during the band tightening procedure. This requires regrasping the tube end of the band 10 and the tab 18 several times during the procedure, which increases both the operation time and the complexity of the operation.
Accordingly there is a need for an improved grasping and pushing tool used in tightening a band having a buckle end and a free end that does not disengage unintentionally and provides better stability and control during the tightening procedure.
In general, in one aspect, the invention features an endoscopic surgical hook tool used in minimally invasive surgery for grasping and tightening a ligature band. The ligature band comprises an elongated strap having a buckle end and a distal end. The buckle end has an aperture and a pull tab having a hole. The elongated strap is configured to encircle an internal organ and the distal end is configured to pass through and lockingly engage the aperture thereby tightening the ligature band around the internal organ. The hook tool includes an elongated shaft having a hook end and a handle. The hook end is configured to engage the hole and pull the pull tab in a first direction while the distal end is threaded and pushed through the aperture, opposite to the first direction. The hook end comprises a flat portion and a bend portion extending from the flat portion. The flat portion is configured to slide along a flat surface of the pull tab and the bend portion has an inner surface radius matching a radius of the hole.
Implementations of this aspect of the invention may include one or more of the following features. The elongated shaft is dimensioned to enter one end, pass through and extend beyond the other end of the cannula. The handle is configured to provide tactile control of the hook end orientation. The handle comprises a cylindrical body having first and second side indentations opposite to each other and a thumb indentation on a top surface of the cylindrical body, the thumb indentation being aligned with the bend portion of the hook end. The hook end further comprises an extension portion extending from the bend portion, running parallel to the flat portion and pointing towards the handle. The internal organ may be a stomach, artery, intestines, heart, lung, pancreas, kidney, bone or liver. In general, in another aspect, the invention features an endoscopic surgical hook tool used in minimally invasive surgery through a cannula for grasping and pulling an elongated strap having a pull tab. The hook tool includes an elongated shaft having a hook end and a handle. The hook end comprises a flat portion and a bend portion extending from the flat portion and the flat portion is configured to slide along a flat surface of the pull tab and the bend portion is configured to engage and grasp a hole on the pull tab. The bend portion has an inner surface radius matching a radius of the hole.
In general, in another aspect, the invention features an endoscopic surgical instrument used in minimally invasive surgery through a cannula for grasping and tightening a ligature band around an internal organ. The ligature band comprises an elongated strap having a buckle end and a distal end. The buckle end has an aperture and a pull tab having a hole thereon. The elongated strap is configured to encircle the internal organ and the distal end is configured to pass through and lockingly engage the aperture thereby tightening the ligature band around the internal organ. The surgical instrument includes a hook tool configured to engage the hole and pull the pull tab in a first direction while the distal end is threaded and pushed through the aperture, opposite to the first direction. The surgical instrument also includes a pusher tool configured to engage a protuberance of the distal end and push the distal end through the aperture after it has been threaded through it. The hook tool comprises a hook having a flat portion and a bend portion extending from the flat portion and the flat portion is configured to slide along a flat surface of the pull tab and the bend portion has an inner surface radius matching a radius of the hole. The hook tool and the pusher tool apply opposing forces on the ligature band for tightening the ligature band around the internal organ. The hook tool may be used in other non endoscopic procedures.
In general, in another aspect, the invention features a method for tightening a ligature band around an internal organ via minimally invasive surgery. The method includes providing a ligature band comprising an elongated strap having a buckle end and a distal end. The buckle end has an aperture and a pull tab having a hole thereon. Next, inserting the ligature band into a patient's body through a minimally invasive cannula and encircling the internal organ with the elongated strap. Next, inserting a surgical hook tool through the cannula. The hook tool comprises an elongated shaft having a hook end and a handle and the hook end comprises a flat portion and a bend portion extending from the flat portion and the flat portion is configured to slide along a flat surface of the pull tab and the bend portion has an inner surface radius matching a radius of the hole. Next, engaging the hole with the hook end and then pulling the pull tab in a first direction with the hook tool while pushing the distal end through the aperture, opposite to the first direction.
Among the advantages of this invention may be one or more of the following. The bend portion of the hook end together with the extension and the flat portion form a C-shaped hook that grasps securely the pull tab. The risk of unintentional disengagement is very low. The extension helps prevent slippage of the hook out of the hole. The inner surface of the bend portion is formed with a radius that matches the inside of the hole in the pull tab. This distributes the pulling force uniformly around the hole and prevents damaging of the pull tab during pulling. The flat portion of the hook end allows the hook end to slide easily underneath or above the pull tab.
The details of one or more embodiments of the invention are set forth in the accompanying drawings and description below. Other features, objects and advantages of the invention will be apparent from the following description of the preferred embodiments, the drawings and from the claims.
Referring to the figures, wherein like numerals represent like parts throughout the several views:
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Several embodiments of the present invention have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the invention. Accordingly, other embodiments are within the scope of the following claims.
This application claims the benefit of U.S. provisional application Ser. No. 60/650,284 filed on Feb. 4, 2005 and entitled SURGICAL HOOK INSTRUMENT FOR GASTRIC BAND CLOSING which is commonly assigned and the contents of which are expressly incorporated herein by reference. This application is also related to U.S. provisional application Ser. No. 60/650,290 filed on Feb. 4, 2005 and entitled SURGICAL ROTARY CAPTURE INSTRUMENT FOR GASTRIC BAND CLOSING which is commonly assigned and the contents of which are expressly incorporated herein by reference. This application is also related to U.S. provisional application Ser. No. 60/670,111 filed on Apr. 11, 2005 and entitled GASTRIC BAND INSERTION INSTRUMENT which is commonly assigned and the contents of which are expressly incorporated herein by reference.
Number | Date | Country | |
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60650284 | Feb 2005 | US | |
60650290 | Feb 2005 | US | |
60670111 | Apr 2005 | US |